Provider Demographics
NPI:1346095882
Name:SINGLETON, AVERY PAXTON
Entity Type:Individual
Prefix:MR
First Name:AVERY
Middle Name:PAXTON
Last Name:SINGLETON
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:PO BOX 869
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60690-0869
Mailing Address - Country:US
Mailing Address - Phone:708-821-2350
Mailing Address - Fax:
Practice Address - Street 1:1859 E 71ST ST APT 218
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60649-2045
Practice Address - Country:US
Practice Address - Phone:708-821-2350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-18
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)