MEDICARE: RUBYJO'S TRANSPORTATION LLC

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	342000000X	Transportation Network Company

General Provider Information

NPI Number	:	1942155817
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RUBYJO'S TRANSPORTATION LLC

Provider Business Mailing Address
First Line	:	17910 ESCANABA AVE
Second Line	:
City	:	LANSING
State	:	IL
Zip	:	60438-2118
Country	:	US
Telephone Number	:	312-316-9212
Fax Number	:

Provider Business Practice Location Address
First Line	:	17910 ESCANABA AVE
Second Line	:
City	:	LANSING
State	:	IL
Zip	:	60438-2118
Country	:	US
Telephone Number	:	312-316-9212
Fax Number	:

Authorized Official
Title or Position	:	OWNER/EMPLOYEE
Name	:	MS. CHENETRA CAMPBELL
Credential	:
Telephone Number	:	312-316-9212

Provider Enumeration Date	:	03/04/2026
Last Update Date	:	03/04/2026

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