Village of la Grange Park

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

8305 Issued in IL

Legal business name

VILLAGE OF LA GRANGE PARK

Practice address

447 N Catherine Ave
La Grange Park, IL 60526-2006

Phone

(708) 354-0225

Fax

(708) 482-4425

NPI assigned

Jul 30, 2006

Last updated

Jun 26, 2008By 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

Dean Maggos

Title

Fire Chief

Phone

(708) 354-0225

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• La Grange Park Fire Department Former legal business name

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": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214438400000",
    "number": "1427063130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 457",
            "city": "WHEELING",
            "state": "IL",
            "postal_code": "600900457",
            "telephone_number": "847-577-8811",
            "fax_number": "847-577-7967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "447 N CATHERINE AVE",
            "city": "LA GRANGE PARK",
            "state": "IL",
            "postal_code": "605262006",
            "telephone_number": "708-354-0225",
            "fax_number": "708-482-4425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLAGE OF LA GRANGE PARK",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2008-06-26",
        "status": "A",
        "authorized_official_last_name": "MAGGOS",
        "authorized_official_first_name": "DEAN",
        "authorized_official_title_or_position": "FIRE CHIEF",
        "authorized_official_telephone_number": "708-354-0225"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "IL",
            "license": "8305",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "590014325",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF LABOR OWCP",
            "identifier": "612094800",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1630227",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "La Grange Park Fire Department",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Land Ambulance in La Grange Park, IL
• Providers in La Grange Park, IL by specialty
• Land Ambulance in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 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.