Individual
MS. LESLIE HINES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1856 BERNICE RD, SOUTH HOLLAND, IL 60473-3736
(708) 843-1037
Mailing address
1856 BERNICE RD, SOUTH HOLLAND, IL 60473-3736
(708) 843-1037
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
H52053475770
IL
343900000X
Non-emergency Medical Transport (VAN)
—
—
347C00000X
Private Vehicle
H52053475770
IL
Other
Enumeration date
10/21/2022
Last updated
10/21/2022
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