Organization
NORTHWESTERN MEDIVAN INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MOHAMMED HASAN (VICE PRESIDENT)
(630) 883-8677
Entity
Organization
Contact information
Practice address
480 BLUE HERON CIR, BARTLETT, IL 60103-2307
(630) 883-8677
(630) 883-8676
Mailing address
480 BLUE HERON CIR, BARTLETT, IL 60103-2307
(630) 883-8677
(630) 883-8676
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
13204PT
IL
Other
Enumeration date
08/31/2011
Last updated
08/31/2011
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