Higher Love PSR Special SRVC

Primary specialty

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

License

5678 Issued in IL

Legal business name

HIGHER LOVE PSR SPECIAL SRVC

Practice address

2705 E 83Rd St
Chicago, IL 60617-2007

Phone

(773) 768-7284

NPI assigned

Apr 28, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Kennie Delt

Title

Director

Phone

(773) 768-7284

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1209340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209340800000",
    "number": "1952576217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 DEVONSHIRE DR",
            "city": "CRETE",
            "state": "IL",
            "postal_code": "604171980",
            "telephone_number": "773-768-7284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2705 E 83RD ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606172007",
            "telephone_number": "773-768-7284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIGHER LOVE PSR SPECIAL SRVC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-28",
        "last_updated": "2008-04-28",
        "status": "A",
        "authorized_official_last_name": "DELT",
        "authorized_official_first_name": "KENNIE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "773-768-7284",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "IL",
            "license": "5678",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "432029080001",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Highland Park CVS LLC (CVS Pharmacy #17711)

• 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 28, 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.