Provider Demographics
NPI:1013095017
Name:PRECISE AMBULANCE SERVICE LLC
Entity Type:Organization
Organization Name:PRECISE AMBULANCE SERVICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:HAJDUCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-857-9100
Mailing Address - Street 1:9982 ANDERSON AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60415-1417
Mailing Address - Country:US
Mailing Address - Phone:708-857-9100
Mailing Address - Fax:
Practice Address - Street 1:9982 ANDERSON AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60415-1417
Practice Address - Country:US
Practice Address - Phone:708-857-9100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL71083416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0001636407OtherBLUE CROSS
ILP00201767OtherRAILROAD MEDICARE
IL=========001Medicaid
ILP00201767OtherRAILROAD MEDICARE