MEDICARE: TAMIKA LOVE

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)

General Provider Information

NPI Number	:	1598187676
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAMIKA LOVE

Provider Business Mailing Address
First Line	:	3004 W WABANSIA AVE
Second Line	:	APT 2
City	:	CHICAGO
State	:	IL
Zip	:	60647-5021
Country	:	US
Telephone Number	:	224-355-7882
Fax Number	:

Provider Business Practice Location Address
First Line	:	3004 W WABANSIA AVE
Second Line	:	APT 2
City	:	CHICAGO
State	:	IL
Zip	:	60647-5021
Country	:	US
Telephone Number	:	224-355-7882
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/09/2014
Last Update Date	:	01/09/2014

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Directions to “ TAMIKA LOVE ” Practice Location

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