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General NPI Number Information
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NPI Number | 1821562463
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Entity Type | Organization
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Legal Business Name | MISSION DRIVEN TRANSPORTATION INC
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Dates
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Enumeration Date | 01/16/2019
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Last Update Date | 01/16/2019
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Provider Practice Location Address
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Address Line | 18020 MICHAEL AVE
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City | COUNTRY CLUB HILLS
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State | IL
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Zip | 60478-5022
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Country | US
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Telephone | 630-465-5704
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Fax |
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Provider Business Mailing Address
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Address Line | 18020 MICHAEL AVE
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City | COUNTRY CLUB HILLS
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State | IL
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Zip | 60478-5022
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Country | US
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Telephone | 630-465-5704
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MARIE JOHNSON-REYNOLDS
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Credential |
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Telephone | 708-362-8960
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 344600000X
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Taxonomy Name | Taxi
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 347B00000X
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Taxonomy Name | Bus
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License Number |
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License Number State |
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Taxonomy #4
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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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