MEDICARE: ECO LOGISTICS LTD

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	343900000X	Non-emergency Medical Transport (VAN)
2	344600000X	Taxi
3	347C00000X	Private Vehicle
4	347E00000X	Transportation Broker

General Provider Information

NPI Number	:	1932865953
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ECO LOGISTICS LTD

Provider Business Mailing Address
First Line	:	2535 W JEROME ST APT A
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60645-1544
Country	:	US
Telephone Number	:	312-731-3678
Fax Number	:

Provider Business Practice Location Address
First Line	:	2535 W JEROME ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60645-1543
Country	:	US
Telephone Number	:	312-731-3678
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	IDOWU OLORUNSOLA
Credential	:
Telephone Number	:	312-731-3678

Provider Enumeration Date	:	11/14/2021
Last Update Date	:	11/14/2021

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Directions to “ECO LOGISTICS LTD ” Practice Location

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