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General NPI Number Information
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NPI Number | 1467854687
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Entity Type | Individual
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Provider Name | JOCELYN WELLS
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Gender | Female
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Dates
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Enumeration Date | 09/18/2014
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Last Update Date | 09/18/2014
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Provider Practice Location Address
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Address Line | 15728 DREXEL AVE
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City | DOLTON
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State | IL
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Zip | 60419-2754
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Country | US
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Telephone | 708-849-4770
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Fax | 708-849-4771
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Provider Business Mailing Address
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Address Line | 15728 DREXEL AVE
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City | DOLTON
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State | IL
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Zip | 60419-2754
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Country | US
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Telephone | 708-849-4770
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Fax | 708-849-4771
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343800000X
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Taxonomy Name | Secured Medical Transport (VAN)
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License Number | 7391MC
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number | 7391MC
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License Number State | IL
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