Organization Active NPI

Long Grove Fire Protection District

  • Land Ambulance
  • Long Grove, IL
National Provider Identifier
1689680894
Registry record updated Sep 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
107266 Issued in IL
Legal business name
LONG GROVE FIRE PROTECTION DISTRICT
Practice address
1165 Old McHenry Rd
Long Grove, IL 60047-5088
Phone
(847) 634-3143
Fax
(847) 634-2027
NPI assigned
Jul 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2025

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

Authorized official

Name
Paul Segalla
Title
Fire Chief
Phone
(847) 634-3143

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X 107266 IL Primary

Addresses

Primary practice location

1165 Old McHenry Rd
Long Grove, IL 60047-5088

Mailing address

PO Box 6253
Carol Stream, IL 60197-6253
Phone (630) 530-2988

Other identifiers 2

IdentifierTypeStateIssuer
049-90002OtherILBCBS
590013830OtherILRAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110615000040 IL Part B Supplier - Ambulance Service Supplier 9931386232 Practice locations: Long Grove, IL

National Provider Directory

National Provider Directory

Locations

1165 Old McHenry Rd
Long Grove, IL 60047
Phone (847) 634-3143

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757289600000",
    "number": "1689680894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6253",
            "city": "CAROL STREAM",
            "state": "IL",
            "postal_code": "601976253",
            "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": "1165 OLD MCHENRY RD",
            "city": "LONG GROVE",
            "state": "IL",
            "postal_code": "600475088",
            "telephone_number": "847-634-3143",
            "fax_number": "847-634-2027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONG GROVE FIRE PROTECTION DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-31",
        "last_updated": "2025-09-08",
        "certification_date": "2025-09-08",
        "status": "A",
        "authorized_official_last_name": "SEGALLA",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "FIRE CHIEF",
        "authorized_official_telephone_number": "847-634-3143"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "IL",
            "license": "107266",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "049-90002",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "590013830",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Grove, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 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.