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General NPI Number Information
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NPI Number | 1598186249
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Entity Type | Organization
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Legal Business Name | LET'S GO SHUTTLE SERVICE CORP
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Dates
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Enumeration Date | 12/25/2013
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Last Update Date | 12/25/2013
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Provider Practice Location Address
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Address Line | 14433 S EMERALD AVE
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City | RIVERDALE
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State | IL
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Zip | 60827-2618
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Country | US
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Telephone | 773-610-7607
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Fax | 773-610-7607
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Provider Business Mailing Address
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Address Line | 14433 S EMERALD AVE
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City | RIVERDALE
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State | IL
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Zip | 60827-2618
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Country | US
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Telephone | 773-610-7607
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. GREGORY V BODDEN
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Credential |
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Telephone | 773-610-7607
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number | B352-2988-0172
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License Number State | IL
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