Organization
ESAH TRANSPORTATION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SERGEY YAKOVLEV (PRESIDENT)
(847) 202-1249
Entity
Organization
Contact information
Practice address
815 N CHURCH ST STE 105, ROCKFORD, IL 61110
(847) 489-9000
(815) 489-9001
Mailing address
49 W SLADE ST STE 2, PALATINE, IL 60067
(847) 202-1249
(847) 496-5963
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
7368MC
IL
Other
Enumeration date
08/28/2016
Last updated
08/28/2016
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