Spring Grove Fire Protection

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

7119 Issued in IL

Legal business name

SPRING GROVE FIRE PROTECTION

Practice address

8214 Richardson Rd
Spring Grove, IL 60081-9429

Phone

(815) 675-2450

Fax

(815) 675-6284

NPI assigned

Jul 8, 2006

Last updated

Jun 13, 2024By 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

Paul Klicker

Title

Fire Chief

Phone

(815) 675-2450

Specialties & licenses 1

Addresses

Other identifiers 1

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": "1152316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718236800000",
    "number": "1003849647",
    "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": "847-577-7967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8214 RICHARDSON RD",
            "city": "SPRING GROVE",
            "state": "IL",
            "postal_code": "600819429",
            "telephone_number": "815-675-2450",
            "fax_number": "815-675-6284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPRING GROVE FIRE PROTECTION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-08",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A",
        "authorized_official_last_name": "KLICKER",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "FIRE CHIEF",
        "authorized_official_telephone_number": "815-675-2450"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "IL",
            "license": "7119",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "5632079",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jenny Robbins, PT
• Yuka Ryan, D.C.
• Brian Rybicki, DDS
• Lynn Marie Schmidt, M.S.,CCC-SLP
• Amanda Shirley
• Spring Grove Medical Offices LTD
• Spring Grove Physical Medicine and Rehabilatation LTD
• Spring Grove Physical Therapy LTD
• Spring Grove Wellness
• Starlight Medical Inc

• Land Ambulance in Spring Grove, IL
• Providers in Spring Grove, IL by specialty
• Land Ambulance in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2024; 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.