New Memorial Health EMS Provider

New Provider Information

First Name

Middle Initial

Last Name

Last 4 of SSN

Verify email address

Please list your primary agency within Memorial EMS:

Was your initial IDPH license course after January 1, 2018?

If no, have you completed a bridge course for the Illinois Expanded Scope of Practice?

Level of License

All current licenses, PALS, ACLS, Trauma certifications and CCT certifications should be on file with your employer.