Village of Morton Grove

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

108188 Issued in IL

Legal business name

VILLAGE OF MORTON GROVE

Practice address

6250 Lincoln Ave
Morton Grove, IL 60053-2852

Phone

(847) 470-5226

Fax

(847) 965-7711

NPI assigned

Aug 1, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Thomas J. Friel

Title

Fire Chief

Phone

(847) 470-5226

Specialties & licenses 1

Addresses

Other identifiers 2

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": "1154390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327881600000",
    "number": "1144236951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "395 W LAKE ST",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601261508",
            "telephone_number": "630-903-2372",
            "fax_number": "630-903-2830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6250 LINCOLN AVE",
            "city": "MORTON GROVE",
            "state": "IL",
            "postal_code": "600532852",
            "telephone_number": "847-470-5226",
            "fax_number": "847-965-7711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLAGE OF MORTON GROVE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-01",
        "last_updated": "2012-01-30",
        "status": "A",
        "authorized_official_last_name": "FRIEL",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "FIRE CHIEF",
        "authorized_official_telephone_number": "847-470-5226",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "IL",
            "license": "108188",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "016-70646",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "590013814",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Land Ambulance in Morton Grove, IL
• Providers in Morton 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 Jan 30, 2012; 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.