Individual provider Active NPI

Trevor J Densmore

  • Non-emergency Medical Transport (VAN)
  • Chicago, IL
National Provider Identifier
1265966501
Registry record updated Apr 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-emergency Medical Transport (VAN)Taxonomy code 343900000X
License
D525-8009-0075 Issued in IL
Practice address
2743 W Congress Pkwy
1W
Chicago, IL 60612-3485
Phone
(779) 791-6921
NPI assigned
Apr 13, 2017
Last updated
Apr 13, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 13, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-emergency Medical Transport (VAN) 343900000X D525-8009-0075 IL Primary

Addresses

Primary practice location

2743 W Congress Pkwy
1W
Chicago, IL 60612-3485

Mailing address

2743 W Congress Pkwy
1W
Chicago, IL 60612-3485
Phone (779) 791-6921

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
D525-8009-0075ILMDNon-emergency Medical Transport (VAN)

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1492041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492041600000",
    "number": "1265966501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2743 W CONGRESS PKWY",
            "address_2": "1W",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123485",
            "telephone_number": "779-791-6921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2743 W CONGRESS PKWY",
            "address_2": "1W",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123485",
            "telephone_number": "779-791-6921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENSMORE",
        "first_name": "TREVOR",
        "middle_name": "J",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-04-13",
        "last_updated": "2017-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "IL",
            "license": "D525-8009-0075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2017; 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.