Organization Active NPI

Palos Heights Fire Protection District

  • Ambulance
  • Palos Heights, IL
National Provider Identifier
1396806287
Registry record updated Jun 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
AmbulanceTaxonomy code 341600000X
Legal business name
PALOS HEIGHTS FIRE PROTECTION DISTRICT
Practice address
12300 S Harlem Avenue
Palos Heights, IL 60463
Phone
(708) 448-4272
NPI assigned
Dec 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2008

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

Authorized official

Name
Jack E Nagle
Title
Fire Chief
Phone
(708) 448-4272

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulance 341600000X Primary

Addresses

Primary practice location

12300 S Harlem Avenue
Palos Heights, IL 60463

Mailing address

12300 S Harlem Avenue
Palos Heights, IL 60463
Phone (708) 448-4272

Other identifiers 1

IdentifierTypeStateIssuer
1670910OtherILBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040614000744 IL Part B Supplier - Ambulance Service Supplier 5597749176 Practice locations: Palos Heights, IL

National Provider Directory

National Provider Directory

Locations

13101 S Ridgeland Ave
Palos Heights, IL 60463
Phone (708) 448-4272

12300 S Harlem Ave
Palos Heights, IL 60463
Phone (708) 448-4272

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213315200000",
    "number": "1396806287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12300 S HARLEM AVENUE",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "60463",
            "telephone_number": "708-448-4272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12300 S HARLEM AVENUE",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "60463",
            "telephone_number": "708-448-4272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALOS HEIGHTS FIRE PROTECTION DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2008-06-13",
        "status": "A",
        "authorized_official_last_name": "NAGLE",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "FIRE CHIEF",
        "authorized_official_telephone_number": "708-448-4272"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1670910",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palos Heights, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2008; 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.