OSF LIFELINE AMBULANCE, LLC (NPI# 1619036829) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1619036829 |
Entity Type | Organization |
Organization Name | OSF LIFELINE AMBULANCE, LLC |
Practice Address |
318 Roxbury Rd Rockford IL 61107-5090 |
Mailing Address |
Po Box 17115 Rockford IL 61110-7115 |
Practice Telephone | 8153954695 |
Practice Fax Number | 8053954643 |
Enumeration Date | 2006-12-06 |
Last Update Date | 2014-04-09 |
Authorized Official Name | JAMES M MOORE (CEO) |
Authorized Official Telephone | 3096552850 |
Is Organization Subpart | Y |
Parent Organization Name | OSF HEALTHCARE SYSTEM |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 3416L0300X |
Ambulance Specialization: Land Transport |
Transportation Services |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IL | BLUE CROSS | 471203 | 01 |
Street Address |
318 ROXBURY RD |
City | ROCKFORD |
State | IL |
Zip Code | 61107-5090 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1356952139 | Jessica Marie Tamayo Fernandez | Pharmacist | 1145 Alpine Rd, Rockford, IL 61107 | 2020-08-13 |
1467092379 | Unknown Safa Fatima | Student in an Organized Health Care Education/Training Program | Mercyhealth Mulford Clinic, 5970 Churchview Drive, Rockford, IL 61107 | 2020-01-08 |
1194367912 | Matt J Kriebs | Nurse Practitioner | 1235 N Mulford Rd Suite 103, Rockford, IL 61107 | 2019-10-14 |
1265962336 | Mary Golembeck | Nurse Practitioner | 7290 Argus Dr, Rockford, IL 61107 | 2017-06-12 |
1831644749 | Tessa Lee | Occupational Therapist | 3422 Lauderdale Ln, Rockford, IL 61107 | 2016-08-20 |
1942626965 | Elevated Health Essentials, LLC | Chiropractor | 124 N Water St Ste 204e, Rockford, IL 61107 | 2014-03-14 |
1093139909 | Swedishamerican Hospital | Surgery | 1639 N Alpine Rd Ste 400, Rockford, IL 61107 | 2014-02-12 |
1346676582 | Christopher Anthony Ziganto | Pharmacist | 494 Bienterra Trail #2, Rockford, IL 61107 | 2013-09-19 |
1023358272 | Lavanya Durairajan | Physical Therapist | 7358 Shiligton Dr, Rockford, IL 61107 | 2013-02-26 |
1851523146 | Great Smiles of Rockford | Durable Medical Equipment & Medical Supplies | 780 N. Mulfrord Road, Rockford, IL 61107 | 2009-08-20 |
Find all providers in zip 61107 |
Taxonomy Code | 3416L0300X |
Grouping | Transportation Services |
Classification | Ambulance |
Specialization | Land Transport |
Definition to come... |
Notes: [1/1/2005: title modified] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1740809870 | Blackhawk Fire Protection District | Ambulance | 3738 S Main St, Rockford, IL 61102-4239 | 2020-04-09 |
1275708752 | Mercy Ambulance Service LLC | Ambulance | 1025 Campton Dr, Rockford, IL 61102-1066 | 2008-04-25 |
1790804144 | New Milford Fire Ambulance | Ambulance | 2177 Will James Rd, Rockford, IL 61109-4854 | 2007-03-28 |
1013952589 | Rockford Ambulance Inc | Ambulance | 8450 Shaner Ave Ne, Rockford, MI 49341-9379 | 2006-06-18 |
1720050826 | City of Rockford | Ambulance | 204 S 1st St, Rockford, IL 61104-2033 | 2006-02-02 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1306468871 | Germantown Fire Protection District | Ambulance | 313 Prairie Ave, Germantown Hills, IL 61548-9290 | 2020-05-07 |
1134776859 | Preferred Ambulance LLC | Ambulance | 9449 S Kedzie Ave Ste 301, Evergreen Park, IL 60805-2325 | 2019-08-19 |
1407321938 | Alliance Ambulance LLC | Ambulance | 4248 Belle Aire Lane Suite 3, Downers Grove, IL 60515-1303 | 2018-10-11 |
1366924888 | Randolph Township Fire Protection District | Ambulance | 707 S. Vine St, Heyworth, IL 61745 | 2018-08-31 |
1033615307 | Bridget Mangan | Ambulance | 3559 W 101st St, Evergreen Park, IL 60805-3708 | 2018-04-04 |
1093211823 | Lakeside Ems LLC | Ambulance | 3293 E 500 North Rd, Neoga, IL 62447 | 2018-04-02 |
1902301013 | Ability Transportation Inc | Ambulance | 24459 W Eames St, Channahon, IL 60410-5591 | 2018-03-29 |
1417472739 | City of Benton | Ambulance | 107 N. Maple St., Benton, IL 62812 | 2017-08-08 |
1619499878 | Mission Care of Illinois LLC | Ambulance | 812 N 3rd St, Effingham, IL 62401-3130 | 2017-07-10 |
1538618483 | Lexington Community Fire Protection District | Ambulance | 102 S Benson St, Lexington, IL 61753-1200 | 2016-10-03 |
Find all providers with the same taxonomy |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.