# MID ILLINI NON EMERGENCY PATIENT TRANSPORT LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** ILLINI NON EMERGENCY PATIENT TRANSP
- **Organization subpart:** No

## Provider details

- **NPI number:** 1700599552
- **Authorized official:** JERAMY DOERR (OWNER)
- **Authorized official phone:** (309) 840-4503

## Contact information

- **Practice address:** 3700 N MAIN ST, EAST PEORIA, IL 61611-1447
- **Practice address phone:** (309) 840-4503
- **Mailing address:** PO BOX 589, MADISONVILLE, KY 42431-5011
- **Mailing address phone:** (270) 824-8123
- **Mailing address fax:** (270) 824-8140

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | — | NULL | Yes |

## Other

- **Enumeration date:** 12/26/2022
- **Last updated:** 04/09/2024