TB Transportation Enterprise Inc

Primary specialty

Private VehicleTaxonomy code 347C00000X

Legal business name

TB TRANSPORTATION ENTERPRISE INC

Practice address

4114 W Gladys Ave
Chicago, IL 60624-3284

Phone

(708) 336-9678

NPI assigned

Oct 4, 2019

Organization subpart

No

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

Authorized official

Name

Tommy Wilbourn

Title

Manager

Phone

(708) 336-9678

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

{
    "created_epoch": "1570147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570147200000",
    "number": "1427699081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4114 W GLADYS AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606243284",
            "telephone_number": "708-336-9678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4114 W GLADYS AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606243284",
            "telephone_number": "708-336-9678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TB TRANSPORTATION ENTERPRISE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-04",
        "last_updated": "2019-10-04",
        "status": "A",
        "authorized_official_last_name": "WILBOURN",
        "authorized_official_first_name": "TOMMY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "708-336-9678"
    },
    "taxonomies": [
        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "410014932",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Chicago",
            "affiliation": "N",
            "endpointDescription": "Office",
            "address_1": "4114 W Gladys Ave",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606243284",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2019; 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.