Organization
ILLINOIS VALLEY CITY CAB, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRAD F SHOLDERS (OWNER)
(815) 252-5513
Entity
Organization
Contact information
Practice address
206 3RD ST, LA SALLE, IL 61301-2385
(815) 252-5513
Mailing address
206 3RD ST, LA SALLE, IL 61301-2385
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
344600000X
Taxi
—
—
Other
Enumeration date
09/15/2010
Last updated
09/15/2010
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