Provider Demographics
NPI:1376835850
Name:LAKE ZURICH RURAL FIRE PROTECTION DISTR
Entity Type:Organization
Organization Name:LAKE ZURICH RURAL FIRE PROTECTION DISTR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:MASTANDRIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-540-5070
Mailing Address - Street 1:PO BOX 457
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:IL
Mailing Address - Zip Code:60090-0457
Mailing Address - Country:US
Mailing Address - Phone:847-577-8811
Mailing Address - Fax:847-577-3518
Practice Address - Street 1:321 S BUESCHING RD
Practice Address - Street 2:
Practice Address - City:LAKE ZURICH
Practice Address - State:IL
Practice Address - Zip Code:60047-2535
Practice Address - Country:US
Practice Address - Phone:847-540-5070
Practice Address - Fax:847-540-0165
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-03
Last Update Date:2011-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0972603416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport