Careavan, Inc. of Wisconsin

Primary specialty

Non-emergency Medical Transport (VAN)Taxonomy code 343900000X

Legal business name

CAREAVAN, INC. OF WISCONSIN

Doing business as

CAREAVAN, Inc.

Practice address

7117 Clinton Road
Suite No. 3
Loves Park, IL 61111-3804

Phone

(815) 633-8461

Fax

(815) 633-8486

NPI assigned

Apr 20, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Nicholas James Licary, M.B.A., RT(R)

Title

President and Owner

Phone

(815) 633-8461

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• CAREAVAN, Inc. Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1235356924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7117 CLINTON RD",
            "address_2": "SUITE NO. 3",
            "city": "LOVES PARK",
            "state": "IL",
            "postal_code": "611113804",
            "telephone_number": "815-633-8461",
            "fax_number": "815-633-8486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7117 CLINTON ROAD",
            "address_2": "SUITE NO. 3",
            "city": "LOVES PARK",
            "state": "IL",
            "postal_code": "611113804",
            "telephone_number": "815-633-8461",
            "fax_number": "815-633-8486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAREAVAN, INC. OF WISCONSIN",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-20",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "LICARY",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT AND OWNER",
        "authorized_official_telephone_number": "815-633-8461",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.B.A., RT(R)"
    },
    "taxonomies": [
        {
            "code": "343800000X",
            "taxonomy_group": "",
            "desc": "Secured Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41464300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CAREAVAN, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Holli Burkhart, LMT
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• Kayla Carey, PHMNP
• Ryan Carey
• Glenn M Carguillo, PHARMD
• Katherine I Carlson, PA-C
• Linda Anne Carlson, RPH

• Non-emergency Medical Transport (VAN) in Loves Park, IL
• Providers in Loves Park, IL by specialty
• Non-emergency Medical Transport (VAN) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.