Individual provider Active NPI

Latasha Hubert

  • Non-emergency Medical Transport (VAN)
  • South Holland, IL
National Provider Identifier
1275059263
Registry record updated Aug 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-emergency Medical Transport (VAN)Taxonomy code 343900000X
License
D17150732 Issued in IL
Practice address
17144 Evans Dr
South Holland, IL 60473-3440
Phone
(708) 400-1637
NPI assigned
Aug 21, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 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 D17150732 IL Primary

Addresses

Primary practice location

17144 Evans Dr
South Holland, IL 60473-3440

Mailing address

17144 Evans Dr
South Holland, IL 60473-3440

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
D17150732ILMDNon-emergency Medical Transport (VAN)

NPI Registry JSON

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

{
    "created_epoch": "1503273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503273600000",
    "number": "1275059263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17144 EVANS DR",
            "city": "SOUTH HOLLAND",
            "state": "IL",
            "postal_code": "604733440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17144 EVANS DR",
            "city": "SOUTH HOLLAND",
            "state": "IL",
            "postal_code": "604733440",
            "telephone_number": "708-400-1637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUBERT",
        "first_name": "LATASHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-21",
        "last_updated": "2017-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "IL",
            "license": "D17150732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Holland, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 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.