Provider Demographics
NPI:1982331740
Name:ANGEL MEDICAL VANS INC.
Entity Type:Organization
Organization Name:ANGEL MEDICAL VANS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:NABONG
Authorized Official - Last Name:ABIERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-608-0900
Mailing Address - Street 1:457 STRATFORD RD
Mailing Address - Street 2:
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-2003
Mailing Address - Country:US
Mailing Address - Phone:815-608-0900
Mailing Address - Fax:
Practice Address - Street 1:457 STRATFORD RD
Practice Address - Street 2:
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60016-2003
Practice Address - Country:US
Practice Address - Phone:815-608-0900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-02
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)