Provider Demographics
NPI:1821011297
Name:BYRON FIRE PROTECTION DISTRICT
Entity Type:Organization
Organization Name:BYRON FIRE PROTECTION DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMS COORDINATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:REEVERTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-234-4911
Mailing Address - Street 1:123 N FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:BYRON
Mailing Address - State:IL
Mailing Address - Zip Code:61010
Mailing Address - Country:US
Mailing Address - Phone:815-234-4911
Mailing Address - Fax:815-234-2580
Practice Address - Street 1:123 N FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:BYRON
Practice Address - State:IL
Practice Address - Zip Code:61010
Practice Address - Country:US
Practice Address - Phone:815-234-4911
Practice Address - Fax:815-234-2580
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL135301341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========001Medicaid
ILC43210Medicare UPIN
IL204341Medicare ID - Type Unspecified