Individual
MIRYL GLENNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
680 N LAKE SHORE DR, CHICAGO, IL 60611-4546
(312) 288-6420
Mailing address
6730 N FRANCISCO AVE, CHICAGO, IL 60645-4316
(773) 849-9789
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085.006685
IL
Other
Enumeration date
08/03/2018
Last updated
12/07/2023
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