Healthcare Provider Details

I. General information

NPI: 1366759193
Provider Name (Legal Business Name): THE SHUTTLE PEOPLE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2010
Last Update Date: 08/31/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 155TH ST
CALUMET CITY IL
60409-4559
US

IV. Provider business mailing address

340 155TH ST
CALUMET CITY IL
60409-4559
US

V. Phone/Fax

Practice location:
  • Phone: 773-876-8764
  • Fax: 708-933-0443
Mailing address:
  • Phone: 773-876-8764
  • Fax: 708-933-0443

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343800000X
TaxonomySecured Medical Transport (VAN)
License Number6875 MC
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number6875 MC
License Number StateIL

VIII. Authorized Official

Name: MS. IISIA WALKER
Title or Position: OWNER/SOLE PROPRIETOR
Credential:
Phone: 773-876-8764