Healthcare Provider Details

I. General information

NPI: 1336902923
Provider Name (Legal Business Name): JMD2 TRANSPORTATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2024
Last Update Date: 02/05/2024
Certification Date: 02/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 S CENTRAL AVE
CHICAGO IL
60644-5740
US

IV. Provider business mailing address

124 S CENTRAL AVE
CHICAGO IL
60644-5740
US

V. Phone/Fax

Practice location:
  • Phone: 773-510-2191
  • Fax:
Mailing address:
  • Phone: 773-510-2191
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DARNISHA KING
Title or Position: CEO
Credential:
Phone: 773-510-2191