Organization
FORRESTON FIRE PROTECTION DISTRICT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JACK ROYCE DAWS (PRESIDENT OF BOARD)
(815) 262-3531
Entity
Organization
Contact information
Practice address
301 E. MAIN STREET, FORRESTON, IL 61030-0212
(815) 938-2345
Mailing address
P.O. BOX 260, MENDOTA, IL 61342-0260
(815) 539-2468
(815) 539-6427
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
1369688
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07132001
BCBS OF IL PROVIDER
IL
Enumeration date
03/29/2007
Last updated
06/18/2012
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