Provider Demographics
NPI:1780744417
Name:LELAND FIRE PROTECTION DISTRICT
Entity type:Organization
Organization Name:LELAND FIRE PROTECTION DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD OF TRUSTEE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NORMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WESSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-495-9385
Mailing Address - Street 1:PO BOX 291
Mailing Address - Street 2:
Mailing Address - City:LELAND
Mailing Address - State:IL
Mailing Address - Zip Code:60531-0291
Mailing Address - Country:US
Mailing Address - Phone:815-495-9385
Mailing Address - Fax:815-495-9489
Practice Address - Street 1:180 E. RAILROAD AVENUE
Practice Address - Street 2:
Practice Address - City:LELAND
Practice Address - State:IL
Practice Address - Zip Code:60531-0291
Practice Address - Country:US
Practice Address - Phone:815-495-9385
Practice Address - Fax:815-495-9489
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1 252901341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL05032067OtherBLUE CROSS & BLUE SHIELD
ILP00368407OtherRAILROAD MEDICARE
IL05032067OtherBLUE CROSS & BLUE SHIELD
IL214766Medicare ID - Type Unspecified