Individual
DR. GLADSTONE A TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
036111926
IL
208M00000X
Hospitalist Physician
036111926
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036111926
—
IL
01
—
07332006
BCBS
IL
01
—
229260
COVENTRY
IL
01
—
252364
HARMONY
IL
01
—
699628
HEALTHLINK
IL
01
—
9367182
CIGNA
IL
01
—
P00239844
MEDICARE - RAILROAD
IL
Enumeration date
03/14/2006
Last updated
05/25/2023
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