Amazing Grace Medical Services

Primary specialty

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

Legal business name

AMAZING GRACE MEDICAL SERVICES

Practice address

18401 Dartry Dr
Country Club Hills, IL 60478-5295

Phone

(708) 365-6045

NPI assigned

Jan 28, 2009

Organization subpart

No

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

Authorized official

Name

Adewale Samuel

Title

Manager

Phone

(708) 365-6045

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1233100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233100800000",
    "number": "1992943070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18401 DARTRY DR",
            "city": "COUNTRY CLUB HILLS",
            "state": "IL",
            "postal_code": "604785295",
            "telephone_number": "708-365-6045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18401 DARTRY DR",
            "city": "COUNTRY CLUB HILLS",
            "state": "IL",
            "postal_code": "604785295",
            "telephone_number": "708-365-6045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMAZING GRACE MEDICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-28",
        "last_updated": "2009-01-28",
        "status": "A",
        "authorized_official_last_name": "SAMUEL",
        "authorized_official_first_name": "ADEWALE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "708-365-6045"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Non-emergency Medical Transport (VAN) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2009; 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.