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General NPI Number Information
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NPI Number | 1871969485
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Entity Type | Organization
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Legal Business Name | LOYOLA MEDICINE TRANSPORT LLC
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Dates
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Enumeration Date | 08/18/2015
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Last Update Date | 01/29/2026
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Provider Practice Location Address
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Address Line | 905 W NORTH AVE
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City | MELROSE PARK
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State | IL
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Zip | 60160-1516
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Country | US
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Telephone | 708-538-5307
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Fax |
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Provider Business Mailing Address
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Address Line | 905 W NORTH AVE
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City | MELROSE PARK
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State | IL
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Zip | 60160-1523
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Country | US
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Telephone | 708-538-5307
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Fax |
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | MS. MELISSA LUKASICK
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Credential |
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Telephone | 708-216-5723
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number |
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License Number State |
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