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General NPI Number Information
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NPI Number | 1780028035
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Entity Type | Organization
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Legal Business Name | TRANS-A-WAY
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Dates
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Enumeration Date | 04/17/2013
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Last Update Date | 04/17/2013
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Provider Practice Location Address
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Address Line | 4850 S LAKE PARK AVE SUITE #210
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City | CHICAGO
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State | IL
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Zip | 60615-2130
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Country | US
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Telephone | 312-804-2141
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Fax |
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Provider Business Mailing Address
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Address Line | 4850 S LAKE PARK AVE SUITE #210
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City | CHICAGO
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State | IL
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Zip | 60615-2130
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SOLE PROPRIETOR
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Name | LAKEISHA BARNES
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Credential |
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Telephone | 312-804-2141
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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 | B652-5207-7812
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License Number State | IL
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