Provider Demographics
NPI:1912179847
Name:SPECIALTY NEEDS TRANSPORTATION, INC.
Entity Type:Organization
Organization Name:SPECIALTY NEEDS TRANSPORTATION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:J
Authorized Official - Last Name:VANDENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-614-1343
Mailing Address - Street 1:8400 W 183RD PL
Mailing Address - Street 2:
Mailing Address - City:TINLEY PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60487
Mailing Address - Country:US
Mailing Address - Phone:708-614-1343
Mailing Address - Fax:708-633-1622
Practice Address - Street 1:8400 W 183RD PL
Practice Address - Street 2:
Practice Address - City:TINLEY PARK
Practice Address - State:IL
Practice Address - Zip Code:60487
Practice Address - Country:US
Practice Address - Phone:708-614-1343
Practice Address - Fax:708-633-1622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-01
Last Update Date:2013-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL6536MC343900000X
343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)