MEDICARE: JOSHJOE INCORPORATED

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	347C00000X	Private Vehicle		IL

General Provider Information

NPI Number	:	1972862365
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOSHJOE INCORPORATED

Provider Business Mailing Address
First Line	:	5040 190TH ST
Second Line	:
City	:	COUNTRY CLUB HILLS
State	:	IL
Zip	:	60478-5908
Country	:	US
Telephone Number	:	773-941-4468
Fax Number	:

Provider Business Practice Location Address
First Line	:	5040 190TH ST
Second Line	:
City	:	COUNTRY CLUB HILLS
State	:	IL
Zip	:	60478-5908
Country	:	US
Telephone Number	:	773-941-4468
Fax Number	:	773-941-4469

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MRS. EDITH E IZEGBU
Credential	:
Telephone Number	:	917-640-1542

Provider Enumeration Date	:	05/07/2012
Last Update Date	:	07/21/2022

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Directions to “JOSHJOE INCORPORATED ” Practice Location

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