Provider Demographics
NPI:1205620127
Name:LOVELACE, DARBRIELLE DEVONNA
Entity type:Individual
Prefix:
First Name:DARBRIELLE
Middle Name:DEVONNA
Last Name:LOVELACE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6419 S TALMAN AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60629-1711
Mailing Address - Country:US
Mailing Address - Phone:773-966-9600
Mailing Address - Fax:773-966-9600
Practice Address - Street 1:1636 N BOSWORTH AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60642-7262
Practice Address - Country:US
Practice Address - Phone:773-966-9600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)