Provider Demographics
NPI:1710947387
Name:LOCKPORT TOWNSHIP FIRE PROTECTION DISTRICT
Entity Type:Organization
Organization Name:LOCKPORT TOWNSHIP FIRE PROTECTION DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:R
Authorized Official - Last Name:CRONHOLM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-838-3287
Mailing Address - Street 1:828 E 9TH ST
Mailing Address - Street 2:
Mailing Address - City:LOCKPORT
Mailing Address - State:IL
Mailing Address - Zip Code:60441-3600
Mailing Address - Country:US
Mailing Address - Phone:815-838-3287
Mailing Address - Fax:815-838-9141
Practice Address - Street 1:828 E 9TH ST
Practice Address - Street 2:
Practice Address - City:LOCKPORT
Practice Address - State:IL
Practice Address - Zip Code:60441-3600
Practice Address - Country:US
Practice Address - Phone:815-838-3287
Practice Address - Fax:815-838-9141
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1659899341600000X
IL1659900341600000X
IL1659901341600000X
IL1659902341600000X
IL1659903341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========001Medicaid
IL=========001Medicaid