Organization
MANTENO COMMUNITY FIRE PROTECTION DISTRICT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAURICE O'KEEFE (FIRE CHIEF)
(815) 468-6619
Entity
Organization
Contact information
Practice address
13 S WALNUT ST, MANTENO, IL 60950-1432
(815) 468-6619
(815) 468-7743
Mailing address
PO BOX 457, WHEELING, IL 60090-0457
(847) 577-8811
(847) 577-7967
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
7249
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
370922463
BCBS MISSOURI
MI
01
—
4625410
BCBS
IL
01
—
590013652
RR MEDICARE
IL
01
—
610717000
DOL OWCP
IL
Enumeration date
05/27/2006
Last updated
05/19/2011
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