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General NPI Number Information
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NPI Number | 1790699809
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Entity Type | Organization
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Legal Business Name | SAPPHIRE ELITE LLC
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Dates
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Enumeration Date | 09/28/2026
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Last Update Date | 09/28/2026
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Provider Practice Location Address
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Address Line | 10029 S CALUMET AVE
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City | CHICAGO
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State | IL
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Zip | 60628-2121
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Country | US
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Telephone | 872-387-2041
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Fax |
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Provider Business Mailing Address
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Address Line | 1655 S BLUE ISLAND AVE # 481
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City | CHICAGO
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State | IL
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Zip | 60608-2133
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Country | US
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Telephone | 872-387-2041
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KENNETH PAYNE
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Credential |
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Telephone | 708-893-1356
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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 |
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License Number State | NULL
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