Organization Active NPI

Tri State Fire Protection District

  • Land Ambulance
  • Darien, IL
National Provider Identifier
1558394197
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
7124 Issued in IL
Legal business name
TRI STATE FIRE PROTECTION DISTRICT
Practice address
419 Plainfield Rd
Darien, IL 60561-4207
Phone
(630) 323-6445
NPI assigned
Jul 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
Al Hagy
Title
Chief Administrator
Phone
(630) 323-6445

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X 7124 IL Primary

Addresses

Primary practice location

419 Plainfield Rd
Darien, IL 60561-4207

Mailing address

PO Box 457
Wheeling, IL 60090-0457
Phone (847) 577-8811

Other identifiers 1

IdentifierTypeStateIssuer
2232471OtherILBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070921000211 IL Part B Supplier - Ambulance Service Supplier 2264526250 Practice locations: Willowbrook, IL; Willow Springs, IL; Darien, IL; Burr Ridge, IL

National Provider Directory

National Provider Directory

Locations

419 Plainfield Rd
Darien, IL 60561
Phone (630) 323-6445

236 Sunrise Ave
Willowbrook, IL 60527
Phone (630) 323-6445

6301 Western Ave
Willowbrook, IL 60527
Phone (630) 323-6445

NPI Registry JSON

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1558394197",
    "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": "419 PLAINFIELD RD",
            "city": "DARIEN",
            "state": "IL",
            "postal_code": "605614207",
            "telephone_number": "630-323-6445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI STATE FIRE PROTECTION DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-08",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "HAGY",
        "authorized_official_first_name": "AL",
        "authorized_official_title_or_position": "CHIEF ADMINISTRATOR",
        "authorized_official_telephone_number": "630-323-6445"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "IL",
            "license": "7124",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "2232471",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Darien, IL

Sources for this page

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