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Organization

MIDWEST MEDIVAN, INC

Active
Other names
Forest City Cab
Organization subpart
No

Provider details

NPI number
Authorized official
MR. NICKOLAS JUPIN (PRESIDENT/CEO)
(815) 977-7552
Entity
Organization

Contact information

Practice address
535 LOVES PARK DR, LOVES PARK, IL 61111-5179
(815) 977-7552
(815) 977-7007
Mailing address
535 LOVES PARK DR, LOVES PARK, IL 61111-5179
(815) 977-7552
(815) 977-7007

Taxonomy

Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary

Other

Enumeration date
11/19/2010
Last updated
03/27/2016
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