MEDICARE: HEALTHCARE PLUS TRANSPORT CORP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	343900000X	Non-emergency Medical Transport (VAN)		IL

General Provider Information

NPI Number	:	1124292404
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTHCARE PLUS TRANSPORT CORP

Provider Business Mailing Address
First Line	:	6037 1/2 N CICERO AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60646-1306
Country	:	US
Telephone Number	:	773-283-0090
Fax Number	:	773-283-1054

Provider Business Practice Location Address
First Line	:	6037 1/2 N CICERO AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60646-1306
Country	:	US
Telephone Number	:	773-283-0090
Fax Number	:	773-283-1054

Authorized Official
Title or Position	:	PAYROLL & BILLING SPECIALIST
Name	:	MR. ANDREW BASA
Credential	:
Telephone Number	:	773-283-0090

Provider Enumeration Date	:	04/17/2008
Last Update Date	:	07/21/2022

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