Perfusion Source LTD

Primary specialty

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

License

6519 MC Issued in IL

Legal business name

PERFUSION SOURCE LTD

Practice address

7725 S East End Ave
Chicago, IL 60649-4503

Phone

(773) 731-7373

NPI assigned

Apr 17, 2008

Last updated

Apr 17, 2008By 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

Mr. Bernard Washington, CCP

Title

President

Phone

(773) 731-7373

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1208390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208390400000",
    "number": "1629242987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7725 S EAST END AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606494503",
            "telephone_number": "773-731-7373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7725 S EAST END AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606494503",
            "telephone_number": "773-731-7373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERFUSION SOURCE LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-17",
        "last_updated": "2008-04-17",
        "status": "A",
        "authorized_official_last_name": "WASHINGTON",
        "authorized_official_first_name": "BERNARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-731-7373",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CCP"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "IL",
            "license": "6519 MC",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Non-emergency Medical Transport (VAN) in Chicago, IL
• Providers in Chicago, 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 Apr 17, 2008; 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.