Provider Demographics
NPI:1114050812
Name:UTICA FIRE PROTECTION DISTRICT
Entity Type:Organization
Organization Name:UTICA FIRE PROTECTION DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMS DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:BIERBOM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-667-4113
Mailing Address - Street 1:2945 N. ROUTE 178
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:IL
Mailing Address - Zip Code:61373
Mailing Address - Country:US
Mailing Address - Phone:815-667-4113
Mailing Address - Fax:
Practice Address - Street 1:2945 N. ROUTE 178
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:IL
Practice Address - Zip Code:61373
Practice Address - Country:US
Practice Address - Phone:815-667-4113
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2011-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225853416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport