Organization
MAPLE PARK AND COUNTRYSIDE FIRE
Active
Other names
Maple Park and Countryside Fire
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN PETERSON (FIRE CHIEF)
(815) 827-3500
Entity
Organization
Contact information
Practice address
305 S. COUNTYLINE ROAD, MAPLE PARK, IL 60151
(815) 827-3500
(815) 827-3746
Mailing address
PO BOX 260, MENDOTA, IL 61342-0260
(815) 539-2468
(815) 539-6427
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
1 1018
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05032052
BLUE CROSS BLUE SHIELD
IL
01
—
5032052
RAILROAD MEDICARE
IL
Enumeration date
08/28/2006
Last updated
04/20/2008
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