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Organization

CHERRY VALLEY FIRE PROTECTION DISTRICT

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOSEPH MICHAEL CORL (FIRE CHIEF)
(815) 332-5382
Entity
Organization

Contact information

Practice address
120 E STATE ST, CHERRY VALLEY, IL 61016
(815) 332-5382
(815) 332-3159
Mailing address
395 W LAKE ST, ELMHURST, IL 60126-1508
(630) 903-1280
(630) 903-2830

Taxonomy

Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
11013
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10132209
BLUE CROSS BLUE SHIELD
IL
01
214125
MEDICARE, PART B
IL
Enumeration date
05/23/2006
Last updated
04/06/2020
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