Provider Demographics
NPI:1710381827
Name:MJKNIGHT ENTERPRISE LLC
Entity Type:Organization
Organization Name:MJKNIGHT ENTERPRISE LLC
Other - Org Name:RELIANT TRANSPORTATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MONIQUE
Authorized Official - Middle Name:JONNEL
Authorized Official - Last Name:MCKNIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-750-0832
Mailing Address - Street 1:5411 S HOYNE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60609-5548
Mailing Address - Country:US
Mailing Address - Phone:773-750-0832
Mailing Address - Fax:773-897-5827
Practice Address - Street 1:5411 S HOYNE AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60609-5548
Practice Address - Country:US
Practice Address - Phone:773-750-0832
Practice Address - Fax:773-897-5827
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-17
Last Update Date:2015-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL04986016343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)