Provider Demographics
NPI:1679526594
Name:DEFOREST WINDSOR FIRE & EMS DISTRICT BOARD
Entity type:Organization
Organization Name:DEFOREST WINDSOR FIRE & EMS DISTRICT BOARD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:LAFEBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-846-4364
Mailing Address - Street 1:PO BOX 547
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:IL
Mailing Address - Zip Code:60090-0547
Mailing Address - Country:US
Mailing Address - Phone:877-200-1191
Mailing Address - Fax:336-740-9793
Practice Address - Street 1:110 S STEVENSON ST
Practice Address - Street 2:
Practice Address - City:DEFOREST
Practice Address - State:WI
Practice Address - Zip Code:53532-1513
Practice Address - Country:US
Practice Address - Phone:608-846-4364
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
1012174OtherPHYSICIAN'S PLUS
204563300OtherWORKER'S COMPENSATION
WI41323200OtherHIRSP
WI0101OtherJOHN DEERE
000082027OtherADVOCARE MCHMO
WI41323200OtherWI RENAL PROGRAM
WI41323200Medicaid
=========001OtherTRICARE
204563300OtherWORKER'S COMPENSATION
WI41323200OtherWI RENAL PROGRAM