Organization
CITY OF KEWANEE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEPHEN WELGAT (INTERIM FIRE CHIEF)
(309) 761-1030
Entity
Organization
Contact information
Practice address
401 E 3RD ST, KEWANEE, IL 61443-2365
(309) 852-2115
Mailing address
401 E 3RD ST, KEWANEE, IL 61443-2365
(309) 852-2115
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
254301
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2543
AMBULANCE PROVIDER LICENS
IL
01
—
590007000
RR
IL
Enumeration date
01/29/2007
Last updated
10/26/2021
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