Organization
GLOMAST HEALTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OLUMUYIDE OMOLE (ADMINISTRATOR)
(312) 823-0886
Entity
Organization
Contact information
Practice address
4341 S DEARBORN ST, CHICAGO, IL 60609-2910
(312) 823-0886
Mailing address
4341 S DEARBORN ST, CHICAGO, IL 60609-2910
(312) 823-0886
(888) 251-1030
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
251J00000X
Nursing Care Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
054065482162
DRIVER'S LICENSE
IL
Enumeration date
07/14/2022
Last updated
08/15/2022
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