Healthcare Provider Details

I. General information

NPI: 1689357295
Provider Name (Legal Business Name): J REEDS TRANSPORTATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2023
Last Update Date: 08/09/2023
Certification Date: 08/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 N AUSTIN AVE STE 225
CHICAGO IL
60639-5010
US

IV. Provider business mailing address

1900 N AUSTIN AVE STE 225
CHICAGO IL
60639-5010
US

V. Phone/Fax

Practice location:
  • Phone: 773-739-7554
  • Fax:
Mailing address:
  • Phone: 773-739-7554
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code342000000X
TaxonomyTransportation Network Company
License Number
License Number State

VIII. Authorized Official

Name: ALBERT JOHNSON
Title or Position: OWNER
Credential:
Phone: 773-739-7554