Provider Demographics
NPI:1962839464
Name:A-ADVANCE AMBULANCE LLC
Entity Type:Organization
Organization Name:A-ADVANCE AMBULANCE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PATIENT ACCOUNTS
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTI
Authorized Official - Middle Name:I
Authorized Official - Last Name:VOGRIG-NICKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-525-3173
Mailing Address - Street 1:9850 W. 190 STREET SUITE B-7
Mailing Address - Street 2:
Mailing Address - City:MOKENA
Mailing Address - State:IL
Mailing Address - Zip Code:60448-5606
Mailing Address - Country:US
Mailing Address - Phone:708-525-3173
Mailing Address - Fax:773-774-4744
Practice Address - Street 1:9850 W 190TH ST STE B-1
Practice Address - Street 2:
Practice Address - City:MOKENA
Practice Address - State:IL
Practice Address - Zip Code:60448-5604
Practice Address - Country:US
Practice Address - Phone:708-525-3173
Practice Address - Fax:708-478-8653
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-30
Last Update Date:2014-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL89633416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport