Provider Demographics
NPI:1578068698
Name:MY MEDICAR
Entity Type:Organization
Organization Name:MY MEDICAR
Other - Org Name:ELIZABETH L COX
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:COX
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER MEDICAR COMPAN
Authorized Official - Phone:815-263-5781
Mailing Address - Street 1:21625 S. SCHOOLHOUSE RD
Mailing Address - Street 2:
Mailing Address - City:NEW LENOX
Mailing Address - State:IL
Mailing Address - Zip Code:60451
Mailing Address - Country:US
Mailing Address - Phone:815-953-5993
Mailing Address - Fax:815-463-9697
Practice Address - Street 1:21625 S. SCHOOLHOUSE RD
Practice Address - Street 2:
Practice Address - City:NEW LENOX
Practice Address - State:IL
Practice Address - Zip Code:60451
Practice Address - Country:US
Practice Address - Phone:815-953-5993
Practice Address - Fax:815-463-9697
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-29
Last Update Date:2018-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL8633MC343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILMCS-10-0006-0886OtherTRANSPORT NON EMERGENCY MEDICAL