Organization Active NPI

Deerfield-Bannockburn Fire Department

  • Land Ambulance
  • Deerfield, IL
National Provider Identifier
1386665560
Registry record updated Sep 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
107278 Issued in IL
Legal business name
DEERFIELD-BANNOCKBURN FIRE DEPARTMENT
Practice address
500 Waukegan Rd
Deerfield, IL 60015-4373
Phone
(847) 945-8951
NPI assigned
Jul 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2025

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

Authorized official

Name
Ian Kazian
Title
Fire Chief
Phone
(847) 945-4066

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X 107278 IL Primary

Addresses

Primary practice location

500 Waukegan Rd
Deerfield, IL 60015-4373

Mailing address

PO Box 1368
Elmhurst, IL 60126-8368
Phone (630) 530-2988

Other identifiers 2

IdentifierTypeStateIssuer
214123OtherILMEDICARE
04932588OtherILBLUE CROSS BLUE SHIELD

Other names 1

  • Deerfield-Bannockburn Fire Protection District Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061023000065 IL Part B Supplier - Ambulance Service Supplier 1557368271 Practice locations: Bannockburn, IL; Deerfield, IL

National Provider Directory

National Provider Directory

Locations

1935 Half Day Rd
Bannockburn, IL 60015
Phone (847) 374-9773

500 Waukegan Rd
Deerfield, IL 60015
Phone (847) 945-4066

NPI Registry JSON

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757030400000",
    "number": "1386665560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1368",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601268368",
            "telephone_number": "630-530-2988",
            "fax_number": "630-832-9750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 WAUKEGAN RD",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600154373",
            "telephone_number": "847-945-8951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEERFIELD-BANNOCKBURN FIRE DEPARTMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-22",
        "last_updated": "2025-09-05",
        "certification_date": "2025-09-05",
        "status": "A",
        "authorized_official_last_name": "KAZIAN",
        "authorized_official_first_name": "IAN",
        "authorized_official_title_or_position": "FIRE CHIEF",
        "authorized_official_telephone_number": "847-945-4066"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "IL",
            "license": "107278",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "214123",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "04932588",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Deerfield-Bannockburn Fire Protection District",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Deerfield-Bannockburn Fire Protection District",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Deerfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2025; 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.