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NPI 1912548611ActiveOrganization· Driver· Calumet Park, IL
Driver in Calumet Park, Illinois, registered in NPPES in October 2019. The authorized official on file is Jerrod William Dale, Ceo.
Overview
| NPI | 1912548611 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Oct 3, 2019 |
| Last updated in NPPES | Oct 3, 2019 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Driver Primary | 172A00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
Other Driver providers in Calumet Park
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