Provider Demographics
NPI:1235675372
Name:JOLLYGLO INTERNATIONAL LIMITED
Entity Type:Organization
Organization Name:JOLLYGLO INTERNATIONAL LIMITED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:O
Authorized Official - Last Name:OLUWOLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-973-6373
Mailing Address - Street 1:671 MUSKEGON AVE
Mailing Address - Street 2:
Mailing Address - City:CALUMET CITY
Mailing Address - State:IL
Mailing Address - Zip Code:60409-3933
Mailing Address - Country:US
Mailing Address - Phone:773-653-6536
Mailing Address - Fax:708-360-5209
Practice Address - Street 1:671 MUSKEGON AVE
Practice Address - Street 2:
Practice Address - City:CALUMET CITY
Practice Address - State:IL
Practice Address - Zip Code:60409-3933
Practice Address - Country:US
Practice Address - Phone:312-973-6373
Practice Address - Fax:708-360-5209
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-12
Last Update Date:2017-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)