| NPI | 1518120682 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATANYIA ERICA GORDON Owner/Operator 773-301-3548 |
| Organization Subpart ? | No |
| Primary Taxonomy | 343900000X Non-emergency Medical Transport (VAN) (Licence: IL G635-5258-0603) |
| Additional Taxonomies | 343900000X Non-emergency Medical Transport (VAN) (Licence: IL C460-5537-1678) |
| 343900000X Non-emergency Medical Transport (VAN) (Licence: IL S160-4207-9142) | |
| 343900000X Non-emergency Medical Transport (VAN) (Licence: IL G635-8005-8226) | |
| 343900000X Non-emergency Medical Transport (VAN) (Licence: IL T630-2446-1638) | |
| 343900000X Non-emergency Medical Transport (VAN) (Licence: IL C460-1615-8923) | |
| Enumeration Date | 2008-07-08 |
| Last Update Date | 2008-07-10 |