Organization
SLIDE TRANSPORTATION
Active
Other names
Slide Transportation
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNICE BRYANT (CEO)
(708) 414-6601
Entity
Organization
Contact information
Practice address
339 N YALE AVE APT G, VILLA PARK, IL 60181-1947
(708) 414-6601
Mailing address
339 N YALE AVE APT G, VILLA PARK, IL 60181-1947
(708) 414-6601
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20190828862939
—
IL
Enumeration date
08/29/2019
Last updated
08/29/2019
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