Provider Demographics
NPI:1407055387
Name:MED-CAB SERVICE LLC
Entity Type:Organization
Organization Name:MED-CAB SERVICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DARLITO
Authorized Official - Middle Name:ALAVA
Authorized Official - Last Name:ORDONEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:224-436-3200
Mailing Address - Street 1:9136 B WAUKEGAN ROAD
Mailing Address - Street 2:
Mailing Address - City:MORTON GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60053-1749
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9136B WAUKEGAN RD
Practice Address - Street 2:
Practice Address - City:MORTON GROVE
Practice Address - State:IL
Practice Address - Zip Code:60053-2119
Practice Address - Country:US
Practice Address - Phone:224-436-3200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-12
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)