Individual
KHAYALA MUSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8915 OLCOTT AVE, MORTON GROVE, IL 60053-1917
(872) 888-4199
Mailing address
8915 OLCOTT AVE, MORTON GROVE, IL 60053-1917
(872) 888-4199
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
82-5449246
—
IL
Enumeration date
09/20/2018
Last updated
09/20/2018
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