# ELGIN MEDI-TRANSPORT, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033165675
- **Authorized official:** DR. ROBIN BARRAZA (VICE PRESIDENT)
- **Authorized official phone:** (847) 697-0202

## Contact information

- **Practice address:** 672 WING ST, ELGIN, IL 60123-2870
- **Practice address phone:** (847) 697-0202
- **Practice address fax:** (847) 697-4736
- **Mailing address:** PO BOX 323, ELGIN, IL 60121-0323
- **Mailing address phone:** (847) 697-0202
- **Mailing address fax:** (847) 697-4736

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 9 7029 | IL | Yes |

## Other

- **Enumeration date:** 05/25/2006
- **Last updated:** 10/07/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 791590124 | RAILROAD MEDICARE | IL |