Healthcare Provider Details

I. General information

NPI: 1396816948
Provider Name (Legal Business Name): AEROCARE MEDICAL TRANSPORT SYSTEM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 02/07/2023
Certification Date: 02/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

472 ROUTE 47 STE F177
SUGAR GROVE IL
60554-8107
US

IV. Provider business mailing address

472 ROUTE 47 STE F177
SUGAR GROVE IL
60554-8107
US

V. Phone/Fax

Practice location:
  • Phone: 630-466-0800
  • Fax: 480-907-2033
Mailing address:
  • Phone: 630-466-0800
  • Fax: 480-907-2033

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3416A0800X
TaxonomyAir Ambulance
License Number08-0003
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code3416A0800X
TaxonomyAir Ambulance
License Number7 8950
License Number StateIL

VIII. Authorized Official

Name: JOESPH D CECE
Title or Position: CEO
Credential:
Phone: 630-466-0800