STOCKTON FIRE PROTECTION DIST NPI 1629014774

NPI Information

  • NPI: 1629014774
  • Provider Name: STOCKTON FIRE PROTECTION DIST
  • Classification: Emergency Medical Technician, Intermediate - 146M00000X
  • Entity Type: Organization
  • Doing Business As: STOCKTON COMMUNITY AMBULANCE
  • Address: 113 E QUEEN ST
    STOCKTON, IL
    ZIP 61085
  • Phone: (815) 947-3500

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NPI Details

STOCKTON FIRE PROTECTION DIST is an emergency medical technician intermediate in Stockton, IL. The provider is an Intermediate EMT is an individual trained and certified to perform intermediate life support treatment in medical emergencies based on individual state boards. STOCKTON FIRE PROTECTION DIST NPI is 1629014774. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Stockton Community Ambulance.

The provider's business location address is:

113 E QUEEN ST
STOCKTON, IL
ZIP 61085-327
Phone: (815) 947-3500
Fax: (815) 947-9102

The provider's authorized official is Debra J Heidenreich .
The authorized official title is President and has the following contact phone number (815) 947-3023.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Ground mileage, per statute mile (HCPCS:A0425)
  • Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) (HCPCS:A0427)
  • Ambulance service, basic life support, emergency transport (bls-emergency) (HCPCS:A0429)

The enumeration date for this NPI number is 6/20/2006 and was last updated on 5/11/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1146M00000XEmergency Medical Technician, Intermediate100802ILLINOISNo
23416L0300XAmbulanceLand Transport100802ILLINOISNo
33416L0300XAmbulanceLand Transport100803ILLINOISNo
4146N00000XEmergency Medical Technician, Basic100803ILLINOISNo
5146N00000XEmergency Medical Technician, Basic100802ILLINOISNo
6146M00000XEmergency Medical Technician, Intermediate100803ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1205050MEDICARE ID-TYPE UNSPECIFIED
2=========001MEDICAIDILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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