MEDICARE: IMAAD SUPPORT SERVICES

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	342000000X	Transportation Network Company

General Provider Information

NPI Number	:	1639036957
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IMAAD SUPPORT SERVICES

Provider Business Mailing Address
First Line	:	1817 N 14TH ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53205-1641
Country	:	US
Telephone Number	:	920-318-7138
Fax Number	:

Provider Business Practice Location Address
First Line	:	1817 N 14TH ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53205-1641
Country	:	US
Telephone Number	:	920-318-7138
Fax Number	:

Authorized Official
Title or Position	:	OWNER CEO
Name	:	FATUMA SHALE
Credential	:
Telephone Number	:	920-318-7138

Provider Enumeration Date	:	01/08/2026
Last Update Date	:	01/08/2026

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Directions to “IMAAD SUPPORT SERVICES ” Practice Location

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