Individual
MRS. AQUEELAH FORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10026 S KEDZIE AVE STE A, EVERGREEN PARK, IL 60805-3420
(312) 448-3016
Mailing address
10026 S KEDZIE AVE STE A, EVERGREEN PARK, IL 60805-3420
(312) 448-3016
Taxonomy
Speciality
Code
Description
License number
State
343800000X
Secured Medical Transport (VAN)
Primary
F63001882807
IL
Other
Enumeration date
08/02/2021
Last updated
08/02/2021
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