Crown Medicare Inc.

Primary specialty

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

Legal business name

CROWN MEDICARE INC.

Practice address

2243 S 24TH Ave
Broadview, IL 60155-3820

Phone

(708) 338-3305

Fax

(708) 338-3306

NPI assigned

Jun 11, 2008

Last updated

Jun 11, 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. Aderemi Otesile

Title

Ceo

Phone

(708) 338-3305

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1213142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213142400000",
    "number": "1780844910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2243 S 24TH AVE",
            "city": "BROADVIEW",
            "state": "IL",
            "postal_code": "601553820",
            "telephone_number": "708-338-3305",
            "fax_number": "708-338-3306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2243 S 24TH AVE",
            "city": "BROADVIEW",
            "state": "IL",
            "postal_code": "601553820",
            "telephone_number": "708-338-3305",
            "fax_number": "708-338-3306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROWN MEDICARE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-11",
        "last_updated": "2008-06-11",
        "status": "A",
        "authorized_official_last_name": "OTESILE",
        "authorized_official_first_name": "ADEREMI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "708-338-3305",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Non-emergency Medical Transport (VAN) in Broadview, IL
• Providers in Broadview, 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 Jun 11, 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.