| NPI | 1023219094 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD L KOELLING President / Supervisor 815-865-5153 |
| Organization Subpart ? | No |
| Primary Taxonomy | 146L00000X Emergency Medical Technician, Paramedic (Licence: IL 01103601) |
| Additional Taxonomies | 146M00000X Emergency Medical Technician, Intermediate |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2012-03-28 |