Village of East Hazel Crest

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

VILLAGE OF EAST HAZEL CREST

Doing business as

East Hazel Crest Fire Department

Practice address

17223 Throop St
East Hazel Crest, IL 60429-1949

Phone

(708) 798-3902

Fax

(708) 206-0148

NPI assigned

Aug 7, 2025

Organization subpart

No

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

Authorized official

Name

Thomas A Brown

Title

Village President

Phone

(708) 798-0213

Specialties & licenses 1

Addresses

Other names 1

• East Hazel Crest Fire Department Doing business as

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": "1754524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755648000000",
    "number": "1407731631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1904 174TH ST",
            "city": "EAST HAZEL CREST",
            "state": "IL",
            "postal_code": "604291442",
            "telephone_number": "708-798-3902",
            "fax_number": "708-206-0148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17223 THROOP ST",
            "city": "EAST HAZEL CREST",
            "state": "IL",
            "postal_code": "604291949",
            "telephone_number": "708-798-3902",
            "fax_number": "708-206-0148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLAGE OF EAST HAZEL CREST",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-07",
        "last_updated": "2025-08-20",
        "certification_date": "2025-08-20",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "VILLAGE PRESIDENT",
        "authorized_official_telephone_number": "708-798-0213"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "East Hazel Crest Fire Department",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "East Hazel Crest Fire Department",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Venice Thompson
• Total Medical Services, Inc.
• Jason Trotter, B.A.
• Tara Turner I, 19935
• Joella Louise Upton
• Linda Wagner I, MHS,CADC,MISA I
• Linda Wetherspoon
• Crystal Ann Williams, CADC, LPN
• Glinda Wilson, CADC/MISA1
• Gabrielle Wright

• Land Ambulance in East Hazel Crest, IL
• Providers in East Hazel Crest, IL by specialty
• Land Ambulance in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 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.