Healthcare Provider Details

I. General information

NPI: 1457208761
Provider Name (Legal Business Name): MIDWEST MEDICAL TRANSPORTATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2026
Last Update Date: 03/16/2026
Certification Date: 03/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7527 BRISTOL LN UNIT 2
HANOVER PARK IL
60133-2591
US

IV. Provider business mailing address

7527 BRISTOL LN UNIT 2
HANOVER PARK IL
60133-2591
US

V. Phone/Fax

Practice location:
  • Phone: 847-529-2614
  • Fax:
Mailing address:
  • Phone: 847-529-2614
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number State

VIII. Authorized Official

Name: JOSEPH MUGISHA
Title or Position: OWNER
Credential:
Phone: 847-529-2614