Provider Demographics
NPI:1225600760
Name:ALOHAN, PRESLEY OSAGIE
Entity Type:Individual
Prefix:MR
First Name:PRESLEY
Middle Name:OSAGIE
Last Name:ALOHAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17538 MULBERRY AVE
Mailing Address - Street 2:
Mailing Address - City:TINLEY PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60487-6162
Mailing Address - Country:US
Mailing Address - Phone:773-629-5901
Mailing Address - Fax:
Practice Address - Street 1:17538 MULBERRY AVE
Practice Address - Street 2:
Practice Address - City:TINLEY PARK
Practice Address - State:IL
Practice Address - Zip Code:60487-6162
Practice Address - Country:US
Practice Address - Phone:773-629-5901
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-14
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)