Organization
BLAM MOBIL BILLBOARDS & TRANSPORTATION INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LARRY LEE KIZER (PRESIDENT)
(773) 512-4555
Entity
Organization
Contact information
Practice address
14927 COTTAGE GROVE AVE, DOLTON, IL 60419-2131
(312) 326-3183
(312) 326-3183
Mailing address
500 E 33RD ST, SUITE 900, CHICAGO, IL 60616-4056
(312) 326-3183
(312) 326-3183
Taxonomy
Speciality
Code
Description
License number
State
343800000X
Secured Medical Transport (VAN)
—
IL
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001
—
IL
Enumeration date
07/05/2010
Last updated
07/05/2010
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