Individual
MR. EMERSON BRANCH III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
10821 S HALE AVE, CHICAGO, IL 60643-3335
(773) 851-1709
Mailing address
9449 S KEDZIE AVE STE 206, EVERGREEN PK, IL 60805-2325
Taxonomy
Speciality
Code
Description
License number
State
343800000X
Secured Medical Transport (VAN)
—
—
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
347C00000X
Private Vehicle
—
—
Other
Enumeration date
03/12/2024
Last updated
03/12/2024
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