Provider Demographics
NPI:1881633204
Name:NEWPORT FIRE PROTECTION DISTRICT
Entity Type:Organization
Organization Name:NEWPORT FIRE PROTECTION DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:KIRSCHHOFFER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-336-1080
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:630-903-2381
Mailing Address - Fax:
Practice Address - Street 1:39010 N CAROLINE AVE
Practice Address - Street 2:
Practice Address - City:WADSWORTH
Practice Address - State:IL
Practice Address - Zip Code:60083-8923
Practice Address - Country:US
Practice Address - Phone:847-336-1080
Practice Address - Fax:847-336-1097
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-05
Last Update Date:2020-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL72983416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL4920463OtherBCBS
IL590013134OtherRR MEDICARE
IL=========001Medicaid
IL215933Medicare PIN