Organization
IMG AMBULANCE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KONSTANTIN KIPIANI (OWNER)
(847) 687-2241
Entity
Organization
Contact information
Practice address
28915 N HERKY DR STE 103, LAKE BLUFF, IL 60044-1466
(847) 687-2241
Mailing address
28915 N HERKY DR STE 103, LAKE BLUFF, IL 60044-1466
(847) 687-2241
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
—
—
Other
Enumeration date
12/10/2020
Last updated
10/20/2023
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