Provider Demographics
NPI:1922021393
Name:STILLMAN FIRE PROTECTION DISTRICT
Entity Type:Organization
Organization Name:STILLMAN FIRE PROTECTION DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:JERAMI
Authorized Official - Last Name:HOEFLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-645-8110
Mailing Address - Street 1:200 S RURAL ST
Mailing Address - Street 2:
Mailing Address - City:STILLMAN VALLEY
Mailing Address - State:IL
Mailing Address - Zip Code:61084
Mailing Address - Country:US
Mailing Address - Phone:815-645-8110
Mailing Address - Fax:815-645-8433
Practice Address - Street 1:200 S RURAL ST
Practice Address - Street 2:
Practice Address - City:STILLMAN VALLEY
Practice Address - State:IL
Practice Address - Zip Code:61084
Practice Address - Country:US
Practice Address - Phone:815-645-8110
Practice Address - Fax:815-645-8433
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2020-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL135201341600000X
IL135202341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========001Medicaid
ILC45966Medicare UPIN
IL249790Medicare ID - Type Unspecified