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General NPI Number Information
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NPI Number | 1477287217
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Entity Type | Organization
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Legal Business Name | EMPLOYEE BENEFIT BUSINESS GROUP INC
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Dates
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Enumeration Date | 07/15/2022
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Last Update Date | 07/19/2022
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Provider Practice Location Address
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Address Line | 1642 MAPLE AVE
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City | BERWYN
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State | IL
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Zip | 60402-1546
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Country | US
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Telephone | 847-436-8623
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Fax | 815-364-6224
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Provider Business Mailing Address
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Address Line | 1642 MAPLE AVE
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City | BERWYN
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State | IL
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Zip | 60402-1546
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Country | US
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Telephone | 847-436-8623
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Fax | 815-364-6224
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MICHAEL ALLEN STINSON
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Credential |
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Telephone | 847-343-6186
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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 |
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