# LIFEGUARD AMBULANCE SERVICE OF ILLINOIS INC.

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** LIFEGUARD AMBULANCE SERVICE OF ILLINOIS INC.
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1255832564
- **Legal business name:** LIFEGUARD AMBULANCE SERVICE OF ILLINOIS INC.
- **Authorized official:** BRIAN SCOTT TIERNEY (EVP, CHIEF FINANCIAL OFFICER)
- **Authorized official phone:** (833) 703-2294

## Contact information

- **Practice address:** 219 W JACKSON ST, MACOMB, IL 61455-2110
- **Practice address phone:** (309) 575-3911
- **Practice address fax:** (309) 833-2140
- **Mailing address:** PO BOX 847199, DALLAS, TX 75284-7199
- **Mailing address phone:** (800) 913-9106

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 341600000X | Ambulance | — | NULL | — |
| 3416L0300X | Land Ambulance | — | NULL | Yes |

## Other

- **Enumeration date:** 02/22/2018
- **Last updated:** 05/13/2026