Aqueelah Ford

Primary specialty

Secured Medical Transport (VAN)Taxonomy code 343800000X

License

F63001882807 Issued in IL

Practice address

10026 S Kedzie Ave Ste a
Evergreen Park, IL 60805-3420

Phone

(312) 448-3016

NPI assigned

Aug 2, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Aqueelah Little Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1627862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627862400000",
    "number": "1851065106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10026 S KEDZIE AVE STE A",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608053420",
            "telephone_number": "312-448-3016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10026 S KEDZIE AVE STE A",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608053420",
            "telephone_number": "312-448-3016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORD",
        "first_name": "AQUEELAH",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-02",
        "last_updated": "2021-08-02",
        "certification_date": "2021-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "343800000X",
            "taxonomy_group": "",
            "desc": "Secured Medical Transport (VAN)",
            "state": "IL",
            "license": "F63001882807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AQUEELAH",
            "last_name": "LITTLE",
            "prefix": "MRS.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Secured Medical Transport (VAN) in Evergreen Park, IL
• Providers in Evergreen Park, IL by specialty
• Secured Medical Transport (VAN) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2021; 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.