Organization
GRANT PARK FIRE PROTECTION DISTRICT
Active
Other names
GRANT PARK EMS
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LAURA LEE VELDHUIZEN RN, PHRN (PREHOSPITAL REGISTERED NURSE)
(815) 465-6123
Entity
Organization
Contact information
Practice address
107 W CURTIS ST, BOX 538, GRANT PARK, IL 60940-7135
(815) 465-6123
(815) 465-6537
Mailing address
PO BOX 457, WHEELING, IL 60090-0457
(847) 577-8811
(847) 577-3518
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
77822
IL
Other
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
Enumeration date
07/09/2006
Last updated
09/22/2009
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