Countryside Fire Protection Dist

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

7273 Issued in IL

Legal business name

COUNTRYSIDE FIRE PROTECTION DIST

Practice address

600 N Deerpath Dr
Vernon Hills, IL 60061-1804

Phone

(847) 367-5511

Fax

(847) 367-5521

NPI assigned

Jul 15, 2006

Last updated

Sep 5, 2025By 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

Charles Smith

Title

Fire Chief

Phone

(847) 367-5511

Specialties & licenses 1

Addresses

Other identifiers 3

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": "1152921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757030400000",
    "number": "1407872831",
    "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": "600 N DEERPATH DR",
            "city": "VERNON HILLS",
            "state": "IL",
            "postal_code": "600611804",
            "telephone_number": "847-367-5511",
            "fax_number": "847-367-5521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTRYSIDE FIRE PROTECTION DIST",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-15",
        "last_updated": "2025-09-05",
        "certification_date": "2025-09-05",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "FIRE CHIEF",
        "authorized_official_telephone_number": "847-367-5511"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "IL",
            "license": "7273",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DOL OWCP",
            "identifier": "132911900",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4971120",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "590013813",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Molly Burnette Corrigan
• Michela Rosanna Coscino
• Karina Costa Bisson
• County of Lake (Nineteenth Judicial Circuit)
• County of Lake (Lake County Health Department and Community Health Center)
• Teresa Cozzens, RN
• Carmen Crawford, LSW
• Michael Cullen II, LCSW

• Land Ambulance in Vernon Hills, IL
• Providers in Vernon Hills, IL by specialty
• Land Ambulance in Illinois

• 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.