Organization
TB TRANSPORTATION ENTERPRISE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TOMMY WILBOURN (MANAGER)
(708) 336-9678
Entity
Organization
Contact information
Practice address
4114 W GLADYS AVE, CHICAGO, IL 60624-3284
(708) 336-9678
Mailing address
4114 W GLADYS AVE, CHICAGO, IL 60624-3284
(708) 336-9678
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
410014932
—
IL
Enumeration date
10/04/2019
Last updated
10/04/2019
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