Provider Demographics
NPI:1073004073
Name:RADIANCE RIDE INC
Entity Type:Organization
Organization Name:RADIANCE RIDE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DAHIR
Authorized Official - Middle Name:O
Authorized Official - Last Name:NUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-931-9239
Mailing Address - Street 1:6246 N MOZART ST APT 2
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60659-1636
Mailing Address - Country:US
Mailing Address - Phone:773-931-9239
Mailing Address - Fax:312-488-9115
Practice Address - Street 1:6246 N MOZART ST APT 2
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60659-1636
Practice Address - Country:US
Practice Address - Phone:773-931-9239
Practice Address - Fax:312-488-9115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-24
Last Update Date:2023-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)