Provider Demographics
NPI:1699914291
Name:KS JET- I TRANSPORTATION, INC
Entity type:Organization
Organization Name:KS JET- I TRANSPORTATION, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO / OWNER/ PARTNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KENYA
Authorized Official - Middle Name:
Authorized Official - Last Name:SIBLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-379-0509
Mailing Address - Street 1:495 CLYDE AVE
Mailing Address - Street 2:SUITE # 4
Mailing Address - City:CALUMET CITY
Mailing Address - State:IL
Mailing Address - Zip Code:60409-3028
Mailing Address - Country:US
Mailing Address - Phone:773-517-4693
Mailing Address - Fax:
Practice Address - Street 1:495 CLYDE AVE APT 4
Practice Address - Street 2:
Practice Address - City:CALUMET CITY
Practice Address - State:IL
Practice Address - Zip Code:60409-3028
Practice Address - Country:US
Practice Address - Phone:773-517-4693
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-05
Last Update Date:2009-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL39430049343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)