Organization
SUNROSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SUNDAY ENMIL PASTORES TRANSPORTATION (PROPRIETOR)
(708) 945-5793
Entity
Organization
Contact information
Practice address
4220 W BELMONT AVE, SUITE 207, CHICAGO, IL 60641-4620
(708) 945-5793
(708) 453-2372
Mailing address
4220 W BELMONT AVE, SUITE 207, CHICAGO, IL 60641-4620
(708) 945-5793
(708) 453-2372
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
P23678563200
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
A2741KD1
—
IL
Enumeration date
12/18/2014
Last updated
12/18/2014
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