Provider Demographics
NPI:1801932991
Name:CITY OF KEWANEE
Entity type:Organization
Organization Name:CITY OF KEWANEE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERIM FIRE CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:WELGAT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:309-761-1030
Mailing Address - Street 1:401 E 3RD ST
Mailing Address - Street 2:
Mailing Address - City:KEWANEE
Mailing Address - State:IL
Mailing Address - Zip Code:61443-2365
Mailing Address - Country:US
Mailing Address - Phone:309-852-2115
Mailing Address - Fax:
Practice Address - Street 1:401 E 3RD ST
Practice Address - Street 2:
Practice Address - City:KEWANEE
Practice Address - State:IL
Practice Address - Zip Code:61443-2365
Practice Address - Country:US
Practice Address - Phone:309-852-2115
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2543013416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL2543OtherAMBULANCE PROVIDER LICENS
IL590007000OtherRR
IL2543OtherAMBULANCE PROVIDER LICENS