# LAKE VILLA FIRE PROTECTION DISTRICT

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1326053034
- **Authorized official:** PETER PARKER (FIRE CHIEF)
- **Authorized official phone:** (847) 356-2992

## Contact information

- **Practice address:** 910 E GRAND AVE, LAKE VILLA, IL 60046-7819
- **Practice address phone:** (847) 356-7376
- **Practice address fax:** (847) 356-3161
- **Mailing address:** PO BOX 457, WHEELING, IL 60090-0457
- **Mailing address phone:** (847) 577-8811
- **Mailing address fax:** (847) 577-7967

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 7095 | IL | Yes |

## Other

- **Enumeration date:** 07/30/2006
- **Last updated:** 04/20/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 4932159 | BCBS | IL |