Provider Demographics
NPI:1346542339
Name:CITY OF LASALLE
Entity Type:Organization
Organization Name:CITY OF LASALLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:ANTONE
Authorized Official - Last Name:BACIDORE
Authorized Official - Suffix:
Authorized Official - Credentials:EMT-BASIC
Authorized Official - Phone:815-223-0834
Mailing Address - Street 1:745 2ND ST
Mailing Address - Street 2:
Mailing Address - City:LA SALLE
Mailing Address - State:IL
Mailing Address - Zip Code:61301-2501
Mailing Address - Country:US
Mailing Address - Phone:815-223-4579
Mailing Address - Fax:815-223-0857
Practice Address - Street 1:745 2ND ST
Practice Address - Street 2:
Practice Address - City:LA SALLE
Practice Address - State:IL
Practice Address - Zip Code:61301-2501
Practice Address - Country:US
Practice Address - Phone:815-223-4579
Practice Address - Fax:815-223-0857
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-23
Last Update Date:2010-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0224823416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport