Village of Park Forest

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

8162 Issued in IL

Legal business name

VILLAGE OF PARK FOREST

Practice address

156 Indianwood Blvd
Park Forest, IL 60466-2044

Phone

(708) 748-5605

Fax

(708) 748-4890

NPI assigned

Jun 7, 2006

Organization subpart

No

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

Authorized official

Name

Robert Wilcox

Title

Fire Chief

Phone

(708) 748-5605

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Park Forest Fire Department Former legal business 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": "1149638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214438400000",
    "number": "1902846215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 457",
            "city": "WHEELING",
            "state": "IL",
            "postal_code": "600900457",
            "telephone_number": "847-577-8811",
            "fax_number": "847-577-7967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "156 INDIANWOOD BLVD",
            "city": "PARK FOREST",
            "state": "IL",
            "postal_code": "604662044",
            "telephone_number": "708-748-5605",
            "fax_number": "708-748-4890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLAGE OF PARK FOREST",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-07",
        "last_updated": "2008-06-26",
        "status": "A",
        "authorized_official_last_name": "WILCOX",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "FIRE CHIEF",
        "authorized_official_telephone_number": "708-748-5605"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "IL",
            "license": "8162",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1670780",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "590006813",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Park Forest Fire Department",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Tru Divine Counseling & Wellness
• David Tyssen, D.C.
• Universal Healthcare Staffing LLC
• Sara E Veldhuizen, LPC
• Victory Centre of Park Forest LLC
• Walgreen Co (Walgreens #04532)
• Carrie Jeanine Wallace-Onifade, LCSW
• Lakeisha Warner, LPN
• Phyllis J Warner
• April Washington, M.ED.

• Land Ambulance in Park Forest, IL
• Providers in Park Forest, IL by specialty
• Land Ambulance in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2008; 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.