Active NPI
Long Grove Fire Protection District
- Land Ambulance
- Long Grove, IL
National Provider Identifier
1689680894
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Land Ambulance
- License
- 107266
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 049-90002 | Other | IL | BCBS |
| 590013830 | Other | IL | RAILROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110615000040 | IL | Part B Supplier - Ambulance Service Supplier | 9931386232 | Practice locations: Long Grove, IL |
National Provider Directory
National Provider DirectoryLocations
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.