Provider Demographics
NPI:1528214681
Name:ASQ MEDICAR
Entity Type:Organization
Organization Name:ASQ MEDICAR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:SEPULVEDA
Authorized Official - Last Name:QUIACHON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-681-8221
Mailing Address - Street 1:908 SAGINAW CT
Mailing Address - Street 2:
Mailing Address - City:CAROL STREAM
Mailing Address - State:IL
Mailing Address - Zip Code:60188-1339
Mailing Address - Country:US
Mailing Address - Phone:630-681-8221
Mailing Address - Fax:
Practice Address - Street 1:908 SAGINAW CT
Practice Address - Street 2:
Practice Address - City:CAROL STREAM
Practice Address - State:IL
Practice Address - Zip Code:60188-1339
Practice Address - Country:US
Practice Address - Phone:630-681-8221
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-08
Last Update Date:2008-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL60048343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)