Village of Gurnee

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

107267 Issued in IL

Legal business name

VILLAGE OF GURNEE

Doing business as

Gurnee Fire Department

Practice address

4580 Grand Avenue
Gurnee, IL 60031-2813

Phone

(847) 599-6600

Fax

(847) 244-8693

NPI assigned

Aug 23, 2006

Last updated

Jul 21, 2022By 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

Mr. Brian C Gosnell

Title

Director of Finance

Phone

(847) 599-7521

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Gurnee Fire Department Doing business as

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": "1156291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1710093372",
    "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": "4580 GRAND AVENUE",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600312813",
            "telephone_number": "847-599-6600",
            "fax_number": "847-244-8693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLAGE OF GURNEE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-23",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "GOSNELL",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "847-599-7521",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "IL",
            "license": "107267",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "590008355",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "04920462",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gurnee Fire Department",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Land Ambulance in Gurnee, IL
• Providers in Gurnee, IL by specialty
• Land Ambulance in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.