Provider Demographics
NPI:1750334504
Name:WOOD DALE FIRE PROTECTION DIST NO 1
Entity type:Organization
Organization Name:WOOD DALE FIRE PROTECTION DIST NO 1
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:F
Authorized Official - Last Name:BURKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-773-1223
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:630-530-2372
Mailing Address - Fax:630-903-2830
Practice Address - Street 1:589 N WOOD DALE RD
Practice Address - Street 2:
Practice Address - City:WOOD DALE
Practice Address - State:IL
Practice Address - Zip Code:60191-1535
Practice Address - Country:US
Practice Address - Phone:630-766-1147
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2020-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL972263416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL022-70502OtherBLUE CROSS BLUE SHILED
IL590013126OtherRAILROAD MEDICARE
IL590013126OtherRAILROAD MEDICARE
IL671410Medicare ID - Type UnspecifiedPART B