Provider Demographics
NPI:1508966466
Name:UNIVERSAL TRANSPORTATION II
Entity Type:Organization
Organization Name:UNIVERSAL TRANSPORTATION II
Other - Org Name:MEDSTAR MEDICAR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:KAPLAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-504-1234
Mailing Address - Street 1:2843 WASHINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:BELLWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60104
Mailing Address - Country:US
Mailing Address - Phone:708-970-0130
Mailing Address - Fax:708-970-0140
Practice Address - Street 1:2843 WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:BELLWOOD
Practice Address - State:IL
Practice Address - Zip Code:60104
Practice Address - Country:US
Practice Address - Phone:708-970-0130
Practice Address - Fax:708-970-0140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL343800000X, 343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered343800000XTransportation ServicesSecured Medical Transport (VAN)
Not Answered343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========001Medicaid