Provider Demographics
NPI:1619922382
Name:CHERRY VALLEY FIRE PROTECTION DISTRICT
Entity Type:Organization
Organization Name:CHERRY VALLEY FIRE PROTECTION DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:CORL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-332-5382
Mailing Address - Street 1:395 W LAKE ST
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-1508
Mailing Address - Country:US
Mailing Address - Phone:630-903-1280
Mailing Address - Fax:630-903-2830
Practice Address - Street 1:120 E STATE ST
Practice Address - Street 2:
Practice Address - City:CHERRY VALLEY
Practice Address - State:IL
Practice Address - Zip Code:61016
Practice Address - Country:US
Practice Address - Phone:815-332-5382
Practice Address - Fax:815-332-3159
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2020-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL110133416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL214125OtherMEDICARE, PART B
IL10132209OtherBLUE CROSS BLUE SHIELD
IL=========001OtherPUBLIC AID