IndividualActive
Jacob Ediba
NPI 1871950782 · Non-emergency Medical Transport (VAN) · Rantoul, IL
Provider details
- NPI number
- 1871950782
- Entity type
- Individual
- Primary specialty
- Non-emergency Medical Transport (VAN)Transportation Services
- Sex
- Male
- Sole proprietor
- Yes
- License
- MCS-10-0005-0464R1 (IL)
Specialties & taxonomies
Transportation Services
Practice location
273 Keystone Dr Apt 5
Rantoul, IL 61866-2774
Phone: (217) 418-7384
Approximate (ZIP-level) locationGet directions
Mailing address
273 Keystone Dr Apt 5
Rantoul, IL 61866-2774
Registry dates
- Enumerated
- 2016-01-22
- Last updated
- 2016-11-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.