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General NPI Number Information
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NPI Number | 1942475686
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Entity Type | Organization
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Legal Business Name | M.D.T. TRANSPORTATION INC.
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Dates
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Enumeration Date | 04/24/2008
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Last Update Date | 04/24/2008
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Provider Practice Location Address
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Address Line | 8000 S CAMPBELL AVE
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City | CHICAGO
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State | IL
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Zip | 60621-3745
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Country | US
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Telephone | 773-434-0480
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Fax | 773-874-3410
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Provider Business Mailing Address
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Address Line | 8000 S CAMPBELL AVE
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City | CHICAGO
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State | IL
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Zip | 60652-2822
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Country | US
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Telephone | 773-434-0480
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Fax | 773-874-3410
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Authorized Official
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Title or Position | MANAGER
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Name | WILLIAM E. HARVEY
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Credential |
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Telephone | 773-434-0480
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 347B00000X
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Taxonomy Name | Bus
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License Number | 3684MC
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License Number State | IL
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