Provider Demographics
NPI:1205421062
Name:A.S.A.P. ROADSIDE ASSISTANCE, LLC
Entity type:Organization
Organization Name:A.S.A.P. ROADSIDE ASSISTANCE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROY
Authorized Official - Middle Name:C
Authorized Official - Last Name:REESE
Authorized Official - Suffix:JR
Authorized Official - Credentials:DD
Authorized Official - Phone:773-717-9921
Mailing Address - Street 1:18125 ROY ST UNIT 402
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:IL
Mailing Address - Zip Code:60438-6628
Mailing Address - Country:US
Mailing Address - Phone:773-717-9921
Mailing Address - Fax:312-688-0272
Practice Address - Street 1:12247 S RACINE AVE
Practice Address - Street 2:
Practice Address - City:CALUMET PARK
Practice Address - State:IL
Practice Address - Zip Code:60643-5401
Practice Address - Country:US
Practice Address - Phone:773-717-9921
Practice Address - Fax:773-688-0272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-03
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172A00000XOther Service ProvidersDriverGroup - Multi-Specialty