Organization
EXPRESS CHARTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TATISHA CLEMONS (CEO)
(773) 309-2100
Entity
Organization
Contact information
Practice address
10507 S WESTERN AVE, CHICAGO, IL 60643-2527
(773) 309-2100
Mailing address
10507 S WESTERN AVE, CHICAGO, IL 60643-2527
(773) 309-2100
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
C45580574850
IL
Other
Enumeration date
06/14/2016
Last updated
06/14/2016
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