Provider Demographics
NPI:1124231899
Name:AIR ANGELS, INC.
Entity Type:Organization
Organization Name:AIR ANGELS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:MCDONALD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-324-2400
Mailing Address - Street 1:PO BOX 2058
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:CA
Mailing Address - Zip Code:95492-2058
Mailing Address - Country:US
Mailing Address - Phone:707-324-2400
Mailing Address - Fax:707-324-2478
Practice Address - Street 1:110 S CLOW INTERNATIONAL PKWY
Practice Address - Street 2:
Practice Address - City:BOLINGBROOK
Practice Address - State:IL
Practice Address - Zip Code:60490-5506
Practice Address - Country:US
Practice Address - Phone:800-761-0940
Practice Address - Fax:630-444-1916
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILX3416A0800X, 3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered3416A0800XTransportation ServicesAmbulanceAir Transport
Not Answered3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========001Medicaid
IL552930Medicare ID - Type UnspecifiedMEDICARE