Provider Demographics
NPI:1366795205
Name:IJG TRANSPORTATION L.L.C.
Entity type:Organization
Organization Name:IJG TRANSPORTATION L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:IVAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:GREAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-692-6942
Mailing Address - Street 1:17002 NOVAK DR
Mailing Address - Street 2:#102
Mailing Address - City:HAZEL CREST
Mailing Address - State:IL
Mailing Address - Zip Code:60429-1155
Mailing Address - Country:US
Mailing Address - Phone:708-692-6942
Mailing Address - Fax:
Practice Address - Street 1:17002 NOVAK DR
Practice Address - Street 2:#102
Practice Address - City:HAZEL CREST
Practice Address - State:IL
Practice Address - Zip Code:60429-1155
Practice Address - Country:US
Practice Address - Phone:708-692-6942
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-16
Last Update Date:2013-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)