Organization
GREATER ROUND LAKE FIRE PROTECTION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARILEE LUCASSEN (ADMINISTRATIVE ASSISTANT)
(847) 546-6001
Entity
Organization
Contact information
Practice address
409 W NIPPERSINK RD, ROUND LAKE, IL 60073-3223
(847) 546-6001
(847) 546-0758
Mailing address
409 W NIPPERSINK RD, ROUND LAKE, IL 60073-3223
(847) 546-6001
(847) 546-0758
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
107274
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04990005
BCBS
IL
01
—
791590040
RAILROAD MEDICARE
IL
Enumeration date
10/10/2006
Last updated
09/08/2025
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