MEDICARE: EZ TRANSPORT SERVICES INC.

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	:	1679072276
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EZ TRANSPORT SERVICES INC.

Provider Business Mailing Address
First Line	:	1762 ARLINGTON LN
Second Line	:
City	:	GLENDALE HEIGHTS
State	:	IL
Zip	:	60139-1892
Country	:	US
Telephone Number	:	630-440-4027
Fax Number	:

Provider Business Practice Location Address
First Line	:	1762 ARLINGTON LN
Second Line	:
City	:	GLENDALE HEIGHTS
State	:	IL
Zip	:	60139-1892
Country	:	US
Telephone Number	:	630-440-4027
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	SYED AFSARULLAH
Credential	:
Telephone Number	:	630-440-4027

Provider Enumeration Date	:	02/08/2018
Last Update Date	:	02/08/2018

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