Provider Demographics
NPI:1942507355
Name:FOX RIVER AND COUNTRYSIDE FIRE RESCUE DISTRICT
Entity Type:Organization
Organization Name:FOX RIVER AND COUNTRYSIDE FIRE RESCUE DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TRUSTEE
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:PARTHUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-815-2741
Mailing Address - Street 1:34W500 CARL LEE RD
Mailing Address - Street 2:
Mailing Address - City:ST CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:60174-5603
Mailing Address - Country:US
Mailing Address - Phone:630-530-2988
Mailing Address - Fax:630-903-2830
Practice Address - Street 1:35W350 CARL LEE ROAD
Practice Address - Street 2:
Practice Address - City:ST CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60175
Practice Address - Country:US
Practice Address - Phone:630-584-3473
Practice Address - Fax:630-584-8266
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-21
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========OtherPUBLIC AID
ILIL5881OtherMEDICARE