Organization
CENTRAL STICKNEY FIRE PROTECTION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN MCMAHON (FIRE CHIEF)
(773) 233-1170
Entity
Organization
Contact information
Practice address
4951 S LOTUS AVE, CHICAGO, IL 60638-1719
(773) 233-1170
(773) 233-8146
Mailing address
PO BOX 438495, CHICAGO, IL 60643-8495
(773) 233-1170
(773) 233-8146
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1636184
HMO ILLINOIS
IL
01
—
590009208
RAILROAD RETIREMENT
IL
Enumeration date
12/26/2006
Last updated
01/30/2012
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