Organization
PINGREE GROVE & C SIDE FPD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIERAN STOUT (FIRE CHIEF)
(847) 741-3151
Entity
Organization
Contact information
Practice address
39W160 PLANK RD, ELGIN, IL 60123-8002
(847) 436-5335
(847) 436-6420
Mailing address
PO BOX 6253, CAROL STREAM, IL 60197-6253
(630) 530-2988
(630) 832-9750
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
97907
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04523024
BCBS
IL
Enumeration date
09/20/2006
Last updated
09/08/2025
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