Provider Demographics
NPI:1477356236
Name:FOLAMI, JENNIFER OLORUNJUEDALO
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:OLORUNJUEDALO
Last Name:FOLAMI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:341 BIENTERRA TRL APT 6
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61107-5853
Mailing Address - Country:US
Mailing Address - Phone:773-359-7849
Mailing Address - Fax:
Practice Address - Street 1:341 BIENTERRA TRL APT 6
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61107-5853
Practice Address - Country:US
Practice Address - Phone:773-359-7849
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-28
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125086395207R00000X, 207P00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program