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General NPI Number Information
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NPI Number | 1033603121
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Entity Type | Organization
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Legal Business Name | TULSA TRANSPORTATION LLC
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Dates
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Enumeration Date | 06/21/2018
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1657 S TROY ST STE B
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City | CHICAGO
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State | IL
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Zip | 60623-2260
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Country | US
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Telephone | 312-933-4859
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Fax |
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Provider Business Mailing Address
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Address Line | 1657 S TROY ST STE B
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City | CHICAGO
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State | IL
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Zip | 60623-2260
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Country | US
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Telephone | 312-933-4859
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Fax |
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Authorized Official
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Title or Position | ASSISTANT
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Name | DAWN L WILLIS
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Credential |
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Telephone | 224-575-2118
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 347E00000X
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Taxonomy Name | Transportation Broker
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License Number |
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License Number State | IL
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