# A-ADVANTAGE AMBULANCE LLC

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

## Provider details

- **NPI number:** 1447621875
- **Authorized official:** KIM DIETZ (DIRECTOR OF PATIENT ACCOUNTS)
- **Authorized official phone:** (708) 995-1187

## Contact information

- **Practice address:** 9850 W 190TH ST, SUITE B-10, MOKENA, IL 60448-5604
- **Practice address phone:** (708) 995-1187
- **Practice address fax:** (708) 995-7230
- **Mailing address:** 9850 W 190TH ST STE B-10, MOKENA, IL 60448-5604
- **Mailing address phone:** (708) 995-1187
- **Mailing address fax:** (708) 995-7230

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 8061 | IL | Yes |
| 343800000X | Secured Medical Transport (VAN) | 8061 | IL | — |

## Other

- **Enumeration date:** 10/12/2015
- **Last updated:** 10/12/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 201379657001 | — | IL |