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Individual

JODY GLASS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
905 CARLISLE RD, BATAVIA, IL 60510-3024
(630) 937-8000
Mailing address
905 CARLISLE RD, BATAVIA, IL 60510-3024

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146005584
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
146005584
SPEECH LANGUAGE PATHOLOGIST
IL
Enumeration date
11/14/2017
Last updated
11/14/2017
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