Provider Demographics
NPI:1023469392
Name:FORWARD DIRECTION CORP
Entity type:Organization
Organization Name:FORWARD DIRECTION CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMED
Authorized Official - Middle Name:
Authorized Official - Last Name:ELBADAWI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-230-2610
Mailing Address - Street 1:2000 W ARTHUR AVE
Mailing Address - Street 2:# 2E
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60645-5544
Mailing Address - Country:US
Mailing Address - Phone:843-230-2610
Mailing Address - Fax:
Practice Address - Street 1:2000 W ARTHUR AVE
Practice Address - Street 2:# 2E
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60645-5544
Practice Address - Country:US
Practice Address - Phone:843-230-2610
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-28
Last Update Date:2016-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILA53455380034343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)