Provider Demographics
NPI:1063014215
Name:CHICAGO EXPRESS TRANSPORTATION
Entity Type:Organization
Organization Name:CHICAGO EXPRESS TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AHMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:SHALAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-738-0660
Mailing Address - Street 1:191 MACARTHUR DR APT 3511
Mailing Address - Street 2:
Mailing Address - City:WILLOWBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60527-3777
Mailing Address - Country:US
Mailing Address - Phone:708-738-0660
Mailing Address - Fax:
Practice Address - Street 1:4325 FRONTAGE RD
Practice Address - Street 2:
Practice Address - City:OAK FOREST
Practice Address - State:IL
Practice Address - Zip Code:60452-4628
Practice Address - Country:US
Practice Address - Phone:708-738-0660
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-12
Last Update Date:2020-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347E00000XTransportation ServicesTransportation Broker