Organization
MARENGO RESCUE SQUAD DISTRICT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALLISON COURTNEY (DISTRICT SECRETARY)
(815) 568-6310
Entity
Organization
Contact information
Practice address
110 TELEGRAPH ST, MARENGO, IL 60152-3155
(815) 568-6310
(815) 568-6430
Mailing address
110 TELEGRAPH ST, MARENGO, IL 60152-3155
(815) 568-6310
(815) 568-6430
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
1706934
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5615142
BLUE CROSS BLUE SHIELD
IL
Enumeration date
05/22/2006
Last updated
08/22/2020
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