# GREATER ROUND LAKE FIRE PROTECTION

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

## Provider details

- **NPI number:** 1588751598
- **Authorized official:** MARILEE LUCASSEN (ADMINISTRATIVE ASSISTANT)
- **Authorized official phone:** (847) 546-6001

## Contact information

- **Practice address:** 409 W NIPPERSINK RD, ROUND LAKE, IL 60073-3223
- **Practice address phone:** (847) 546-6001
- **Practice address fax:** (847) 546-0758
- **Mailing address:** 409 W NIPPERSINK RD, ROUND LAKE, IL 60073-3223
- **Mailing address phone:** (847) 546-6001
- **Mailing address fax:** (847) 546-0758

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 107274 | IL | Yes |

## Other

- **Enumeration date:** 10/10/2006
- **Last updated:** 09/08/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 04990005 | BCBS | IL |
| 01 | — | 791590040 | RAILROAD MEDICARE | IL |