Grant Park Fire Protection District

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

77822 Issued in IL

Legal business name

GRANT PARK FIRE PROTECTION DISTRICT

Practice address

107 W Curtis St
Box 538
Grant Park, IL 60940-7135

Phone

(815) 465-6123

Fax

(815) 465-6537

NPI assigned

Jul 9, 2006

Last updated

Sep 22, 2009By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Laura Lee Veldhuizen, RN, PHRN

Title

Prehospital Registered Nurse

Phone

(815) 465-6123

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• GRANT PARK EMS Other name

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1253577600000",
    "number": "1003849472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 457",
            "city": "WHEELING",
            "state": "IL",
            "postal_code": "600900457",
            "telephone_number": "847-577-8811",
            "fax_number": "847-577-3518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 W CURTIS ST",
            "address_2": "BOX 538",
            "city": "GRANT PARK",
            "state": "IL",
            "postal_code": "609407135",
            "telephone_number": "815-465-6123",
            "fax_number": "815-465-6537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANT PARK FIRE PROTECTION DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-09",
        "last_updated": "2009-09-22",
        "status": "A",
        "authorized_official_last_name": "VELDHUIZEN",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PREHOSPITAL REGISTERED NURSE",
        "authorized_official_telephone_number": "815-465-6123",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN, PHRN"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "IL",
            "license": "77822",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "4670621",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "590013363",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "8181117",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DOL  OWCP",
            "identifier": "611537800",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GRANT PARK EMS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Corryn A Brooks, ATC
• Dana Dickson, RPH
• Kathleen Flanagan
• Chris Gnandt, PT, DPT
• Grant Park Community Unit District 6
• Grant Park School District #6
• Hillary Rose Hubert, ED.S
• Heather Ohm
• Crystal Danae' Pombert, RBT
• Rebecca Schneider

• Land Ambulance in Grant Park, IL
• Providers in Grant Park, IL by specialty
• Land Ambulance in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.