Provider Demographics
NPI:1972226769
Name:ULTIMATE CHOICE TRANSPORTATION LLC
Entity Type:Organization
Organization Name:ULTIMATE CHOICE TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DOMINIQUE
Authorized Official - Middle Name:
Authorized Official - Last Name:CATRON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-441-5626
Mailing Address - Street 1:2304 HOLIDAY TER APT 207
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:IL
Mailing Address - Zip Code:60438-1649
Mailing Address - Country:US
Mailing Address - Phone:708-441-5626
Mailing Address - Fax:
Practice Address - Street 1:55 E MONROE ST STE 3800
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60603-6030
Practice Address - Country:US
Practice Address - Phone:877-785-8462
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-26
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILA2741KD1Medicaid