Provider Demographics
NPI:1326442914
Name:DIVINE CARE TRANSIT INC
Entity Type:Organization
Organization Name:DIVINE CARE TRANSIT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/CEC
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAULINE
Authorized Official - Middle Name:OYIDIYA
Authorized Official - Last Name:OHIRI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-592-9285
Mailing Address - Street 1:6117 N CLAREMONT AVE APT 3N
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60659-5256
Mailing Address - Country:US
Mailing Address - Phone:773-592-9285
Mailing Address - Fax:773-754-7381
Practice Address - Street 1:6117 N CLAREMONT AVE APT 3N
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60659-5256
Practice Address - Country:US
Practice Address - Phone:773-592-9285
Practice Address - Fax:773-754-7381
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-10
Last Update Date:2014-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL68208726343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)