MEDICARE: CHICARE TRANSPORATION

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)

General Provider Information

NPI Number	:	1154190734
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHICARE TRANSPORATION

Provider Business Mailing Address
First Line	:	2600 W PETERSON AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60659-4098
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2600 W PETERSON AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60659-4098
Country	:	US
Telephone Number	:	773-946-0566
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ABDURAHMAN JALALOOTI
Credential	:
Telephone Number	:	773-946-0566

Provider Enumeration Date	:	12/25/2023
Last Update Date	:	12/25/2023

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Directions to “CHICARE TRANSPORATION ” Practice Location

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