Black on Green Transportation

Primary specialty

Private VehicleTaxonomy code 347C00000X

Legal business name

BLACK ON GREEN TRANSPORTATION

Practice address

4125 S Vincennes Ave
Chicago, IL 60653-2714

Phone

(773) 299-0791

NPI assigned

May 16, 2022

Last updated

May 18, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Angelique Momon

Title

Co-Manager

Phone

(773) 299-0791

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1652659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652832000000",
    "number": "1396482998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4125 S VINCENNES AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606532714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4125 S VINCENNES AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606532714",
            "telephone_number": "773-299-0791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLACK ON GREEN TRANSPORTATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-16",
        "last_updated": "2022-05-18",
        "certification_date": "2022-05-18",
        "status": "A",
        "authorized_official_last_name": "MOMON",
        "authorized_official_first_name": "ANGELIQUE",
        "authorized_official_title_or_position": "CO-MANAGER",
        "authorized_official_telephone_number": "773-299-0791"
    },
    "taxonomies": [
        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Private Vehicle in Chicago, IL
• Providers in Chicago, IL by specialty
• Private Vehicle in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2022; 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.