MEDICARE: QUALITY TRANSPORTATION CHICAGO

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)		IL
2	347E00000X	Transportation Broker		IL

General Provider Information

NPI Number	:	1306283064
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	QUALITY TRANSPORTATION CHICAGO

Provider Business Mailing Address
First Line	:	2100 SIBLEY BLVD
Second Line	:
City	:	CALUMET CITY
State	:	IL
Zip	:	60409-2153
Country	:	US
Telephone Number	:	708-646-7375
Fax Number	:

Provider Business Practice Location Address
First Line	:	2100 SIBLEY BLVD
Second Line	:
City	:	CALUMET CITY
State	:	IL
Zip	:	60409-2153
Country	:	US
Telephone Number	:	708-646-7375
Fax Number	:

Authorized Official
Title or Position	:	OWNER/MANAGER
Name	:	MS. SHAQUIDA HUGHES
Credential	:
Telephone Number	:	708-646-7375

Provider Enumeration Date	:	06/03/2013
Last Update Date	:	06/03/2013

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Directions to “QUALITY TRANSPORTATION CHICAGO ” Practice Location

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