MEDICARE: GOOD TO GO INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	343900000X	Non-emergency Medical Transport (VAN)	S30072062278	IL

General Provider Information

NPI Number	:	1104133669
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOOD TO GO INC

Provider Business Mailing Address
First Line	:	1314 N LOCKWOOD AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60651-1479
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1314 N LOCKWOOD AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60651-1479
Country	:	US
Telephone Number	:	773-637-4663
Fax Number	:

Authorized Official
Title or Position	:	SECRETARY
Name	:	LAMARK SCOTT
Credential	:
Telephone Number	:	773-567-7325

Provider Enumeration Date	:	09/06/2010
Last Update Date	:	09/06/2010

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Directions to “GOOD TO GO INC ” Practice Location

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