NPI 1194398776

Ethan Dennis Dahl

Practitioner Basic Emergency Medical Technician Ingleside, IL

Practice location

Address: 306 Washington St, Ingleside, IL 60041-8324
Phone: (847) 587-3312

Registered specialties

Basic Emergency Medical Technician Primary

Emergency Medical Service Providers Taxonomy 146N00000X Licence 060783107 (IL)

Other Emergency Medical Technician, Basic providers in Illinois →

Registry record

NPI: 1194398776
Entity type: Individual
Sex (as registered): Male
NPI issued: 21 Jul 2021
Record last updated: 21 Jul 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.