Individual
JERRON GEDDIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5421 S MAY ST, CHICAGO, IL 60609-6052
(773) 354-5421
Mailing address
5421 S MAY ST, CHICAGO, IL 60609-6052
(773) 354-5421
Taxonomy
Speciality
Code
Description
License number
State
343800000X
Secured Medical Transport (VAN)
G32042068362
IL
343900000X
Non-emergency Medical Transport (VAN)
Primary
G32042068362
IL
347C00000X
Private Vehicle
G32042068362
IL
347E00000X
Transportation Broker
G32042068362
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
46-4868691
—
IL
Enumeration date
02/20/2014
Last updated
02/20/2014
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