City of Highland

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

1690161 Issued in IL

Legal business name

CITY OF HIGHLAND

Practice address

1122 Broadway
Highland, IL 62249-1917

Phone

(618) 654-5901

Fax

(618) 654-6829

NPI assigned

May 24, 2006

Last updated

Mar 27, 2009By 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

Mrs. Stephanie L Nicklin

Title

Billing

Phone

(618) 651-9801

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Highland Ambulance Service Other 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": "1148428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1238112000000",
    "number": "1750336756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2610 PLAZA DR",
            "address_2": "PO BOX 218",
            "city": "HIGHLAND",
            "state": "IL",
            "postal_code": "622491123",
            "telephone_number": "618-651-9801",
            "fax_number": "618-654-1901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1122 BROADWAY",
            "city": "HIGHLAND",
            "state": "IL",
            "postal_code": "622491917",
            "telephone_number": "618-654-5901",
            "fax_number": "618-654-6829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF HIGHLAND",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-24",
        "last_updated": "2009-03-27",
        "status": "A",
        "authorized_official_last_name": "NICKLIN",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "BILLING",
        "authorized_official_telephone_number": "618-651-9801",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "IL",
            "license": "1690161",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF IL",
            "identifier": "0006019802",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "590155556",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Highland Ambulance Service",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Loren Jay Chassels, D.O.
• Chiropractic Specialist, Inc.
• Chiropro of Highland, LLC
• Lalit B Choksi, M.D.
• Christian Social Services of Illinois (Caritas Family Solutions)
• Susan L Collman, NP
• Diane S Connelly
• Madeline Contreras, OTR/L
• Core Health Group PC
• Covenant Care Midwest, Inc. (Highland Health Care Center)

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2009; 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.