ELLEN KIMBERLY JACKSON NPI 1730353400

NPI Information

  • NPI: 1730353400
  • Provider Name: ELLEN KIMBERLY JACKSON
  • Classification: Non-emergency Medical Transport (VAN) - 343900000X
  • Entity Type: Individual
  • Address: 14122 S WABASH AVE
    RIVERDALE, IL
    ZIP 60827
  • Phone: (708) 841-9473

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NPI Details

Ellen Kimberly Jackson is a non emergency medical transport van in Riverdale, IL. The provider is a land vehicle with a capacity to meet special height, clearance, access, and seating, for the conveyance of persons in non-emergency situations. The vehicle may or may not be required to meet local county or state regulations. Ellen Kimberly Jackson NPI is 1730353400. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

14122 S WABASH AVE
RIVERDALE, IL
ZIP 60827-236
Phone: (708) 841-9473
Fax: (708) 880-0172

The enumeration date for this NPI number is 4/14/2008 and was last updated on 4/14/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1343900000XNon-emergency Medical Transport (VAN)ILLINOISYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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