Organization
CAREAVAN, INC. OF WISCONSIN
Active
Other names
CAREAVAN, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NICHOLAS JAMES LICARY M.B.A., RT(R) (PRESIDENT AND OWNER)
(815) 633-8461
Entity
Organization
Contact information
Practice address
7117 CLINTON ROAD, SUITE NO. 3, LOVES PARK, IL 61111-3804
(815) 633-8461
(815) 633-8486
Mailing address
7117 CLINTON RD, SUITE NO. 3, LOVES PARK, IL 61111-3804
(815) 633-8461
(815) 633-8486
Taxonomy
Speciality
Code
Description
License number
State
343800000X
Secured Medical Transport (VAN)
—
—
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41464300
—
WI
Enumeration date
04/20/2007
Last updated
09/11/2025
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