Provider Demographics
NPI:1700193851
Name:CARDINAL VIP TRANSPORTATION
Entity Type:Organization
Organization Name:CARDINAL VIP TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JULIO
Authorized Official - Middle Name:J
Authorized Official - Last Name:BARKAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-651-1407
Mailing Address - Street 1:547 W IDA CT
Mailing Address - Street 2:
Mailing Address - City:MOUNT PROSPECT
Mailing Address - State:IL
Mailing Address - Zip Code:60056-6920
Mailing Address - Country:US
Mailing Address - Phone:847-651-1407
Mailing Address - Fax:
Practice Address - Street 1:547 IDA CT
Practice Address - Street 2:
Practice Address - City:MT PROSPECT
Practice Address - State:IL
Practice Address - Zip Code:60056
Practice Address - Country:US
Practice Address - Phone:847-651-1407
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-10
Last Update Date:2010-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL11839PT343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)