Individual
JOE MATA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
606 OAKLAND AVE APT 212, URBANA, IL 61802
(312) 962-9538
Mailing address
606 OAKLAND AVE APT 212, URBANA, IL 61802-2062
(312) 962-9538
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
347E00000X
Transportation Broker
—
—
Other
Enumeration date
09/20/2017
Last updated
07/21/2022
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