# GRANT PARK FIRE PROTECTION DISTRICT

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- **Entity:** Organization
- **Status:** Active
- **Other names:** GRANT PARK EMS
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003849472
- **Authorized official:** MRS. LAURA LEE VELDHUIZEN RN, PHRN (PREHOSPITAL REGISTERED NURSE)
- **Authorized official phone:** (815) 465-6123

## Contact information

- **Practice address:** 107 W CURTIS ST, BOX 538, GRANT PARK, IL 60940-7135
- **Practice address phone:** (815) 465-6123
- **Practice address fax:** (815) 465-6537
- **Mailing address:** PO BOX 457, WHEELING, IL 60090-0457
- **Mailing address phone:** (847) 577-8811
- **Mailing address fax:** (847) 577-3518

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 77822 | IL | Yes |

## Other

- **Enumeration date:** 07/09/2006
- **Last updated:** 09/22/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 4670621 | BLUE CROSS BLUE SHIELD | IL |
| 01 | — | 590013363 | MEDICARE RAILROAD | IL |
| 01 | — | 611537800 | DOL OWCP | IL |
| 01 | — | 8181117 | UNITED HEALTHCARE | IL |