NPI 1962115857

Mac Limousine Service INC

Organisation PACE Provider Organization Chicago, IL

Practice location

Address: 347 S Cicero Ave, Chicago, IL 60644-4905
Phone: (773) 746-1399
Fax: (773) 626-2118

Authorised official

Name: Derrick Damon McCollum
Title: Ceo
Phone: (773) 746-1399

Registered specialties

PACE Provider Organization Primary

Agencies Taxonomy 251T00000X

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Registry record

NPI: 1962115857
Entity type: Organization
NPI issued: 5 Jan 2023
Record last updated: 19 Jan 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.