Organization
TRACE AMBULANCE INC
Active
Parent organization
AMB TRAN GROUP, LTD
Organization subpart
Yes
Provider details
NPI number
Legal business name
AMB TRAN GROUP, LTD
Authorized official
MR. CHRISTOPHER J VANDENBERG (PRESIDENT)
(708) 614-1343
Entity
Organization
Contact information
Practice address
8400 183RD PL, TINLEY PARK, IL 60477-9268
(708) 614-1343
(708) 633-1622
Mailing address
8400 183RD PL, TINLEY PARK, IL 60487-9205
(708) 614-1343
(708) 570-1652
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
7949
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0005110113
AETNA
IL
01
—
0099220355
BLUE CROSS BLUE SHIELD
IL
01
—
590010440
RAILROAD MEDICARE
IL
01
—
995737
UNITED HEALTHCARE
IL
Enumeration date
05/20/2006
Last updated
01/23/2013
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