Organization
CRESCENT-IROQUOIS EMS & AMBULANCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIM MCCLAIN (CHIEF)
(815) 671-9849
Entity
Organization
Contact information
Practice address
104 N MAPLE ST, CRESCENT CITY, IL 60928-8137
(815) 671-9849
(815) 683-2035
Mailing address
PO BOX 457, WHEELING, IL 60090-0457
(847) 577-8811
(847) 577-3518
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
6773
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
614677500
DEPARTMENT OF LABOR
IL
Enumeration date
05/26/2009
Last updated
03/07/2023
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