Healthcare Provider Details

I. General information

NPI: 1245482355
Provider Name (Legal Business Name): ASSOCIATION FOR INDIVIDUAL DEVELOPMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2008
Last Update Date: 10/31/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1230 N HIGHLAND AVE AID - MEDI-CAR TRANSPORTATION
AURORA IL
60506-1401
US

IV. Provider business mailing address

309 W. NEW INDIAN TRAIL CT.
AURORA IL
60506-2494
US

V. Phone/Fax

Practice location:
  • Phone: 630-966-4300
  • Fax: 630-859-2994
Mailing address:
  • Phone: 630-966-4000
  • Fax: 630-844-2065

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateIL

VIII. Authorized Official

Name: MRS. LYNN O'SHEA
Title or Position: PRESIDENT
Credential:
Phone: 630-966-4001