Organization
CITY OF MINONK OF WOODFORD COUNTY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DEBORAH J STEWART (EMS COORDINATOR)
(309) 432-2730
Entity
Organization
Contact information
Practice address
636 JEFFERSON ST, MINONK, IL 61760-1243
(309) 432-2730
(309) 432-3547
Mailing address
670 N CHESTNUT ST, MINONK, IL 61760-1272
(309) 432-2558
(309) 432-3547
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
22501
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0010215109
BLUE CROSS
IL
01
—
590007853
RAILROAD MEDICARE
IL
Enumeration date
03/23/2007
Last updated
07/30/2012
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