Village of South Holland

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

VILLAGE OF SOUTH HOLLAND

Practice address

16226 Wausau Ave
South Holland, IL 60473-2156

Phone

(773) 233-1170

Fax

(336) 510-5893

NPI assigned

Dec 22, 2006

Organization subpart

No

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

Authorized official

Name

Brian Kolosh

Title

Fire Chief

Phone

(708) 478-5694

Specialties & licenses 2

Addresses

Other identifiers 3

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": "1166745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789171200000",
    "number": "1881759652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1053",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604482052",
            "telephone_number": "708-478-5694",
            "fax_number": "336-510-5893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16226 WAUSAU AVE",
            "city": "SOUTH HOLLAND",
            "state": "IL",
            "postal_code": "604732156",
            "telephone_number": "773-233-1170",
            "fax_number": "336-510-5893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLAGE OF SOUTH HOLLAND",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-22",
        "last_updated": "2026-09-12",
        "certification_date": "2026-09-12",
        "status": "A",
        "authorized_official_last_name": "KOLOSH",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "FIRE CHIEF",
        "authorized_official_telephone_number": "708-478-5694"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMO ILLINOIS",
            "identifier": "1620362",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS OF ILLINOIS",
            "identifier": "1620362",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD RETIREMENT",
            "identifier": "590009878",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• United Evangelistic Consulting Association
• Bhupinder K. Valia, M.D.
• Jenae Vaughn
• Helen Misa Vazquez, MD
• Villa at South Holland LLC
• Jeffrey L Vollmer, LCPC
• Grace Nwaka Wabomnor, ANP
• Walgreen Co
• Chanel Walker, CMA
• Thomas Waller

• Land Ambulance in South Holland, IL
• Providers in South Holland, IL by specialty
• Land Ambulance in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2026; 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.