1013914852 NPI number — OAKBROOK TERRACE FIRE PROTECTION DISTRICT

Table of content: (NPI 1013914852)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013914852 NPI number — OAKBROOK TERRACE FIRE PROTECTION DISTRICT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
OAKBROOK TERRACE FIRE PROTECTION DISTRICT
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1013914852
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/13/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 3366
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OAK BROOK
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60522-3366
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
630-275-4050
Provider Business Mailing Address Fax Number:
630-275-4057

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
17W400 BUTTERFIELD RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OAKBROOK TERRACE
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60181-4045
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
630-834-2759
Provider Business Practice Location Address Fax Number:
630-834-1085
Provider Enumeration Date:
07/07/2005

Additional Information

Authorized Official

Authorized Official Last Name:
SEBESTA
Authorized Official First Name:
GREGORY
Authorized Official Middle Name:
J.
Authorized Official Title or Position:
FINANCE DIRECTOR
Authorized Official Telephone Number:
630-834-2759

Provider Taxonomy Codes

  • Taxonomy code: 341600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3416L0300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2219419 . This is a "BCBS OF IL" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 590008490 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".




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