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General NPI Number Information
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NPI Number | 1346786431
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Entity Type | Organization
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Legal Business Name | KENNEDY J TRANSPORTATION INC
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Dates
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Enumeration Date | 01/12/2017
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Last Update Date | 01/12/2017
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Provider Practice Location Address
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Address Line | 8301 S ASHLAND AVE UNIT 1
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City | CHICAGO
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State | IL
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Zip | 60620-4607
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Country | US
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Telephone | 773-742-9904
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Fax |
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Provider Business Mailing Address
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Address Line | 8301 S ASHLAND AVE UNIT 1
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City | CHICAGO
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State | IL
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Zip | 60620-4607
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Country | US
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Telephone | 773-742-9904
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | KARYN BEARD
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Credential |
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Telephone | 773-742-9904
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number | B63250478923
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License Number State | IL
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