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Organization

DEDICATED HEALTH ILLINOIS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JILL MARIE GLENN (OWNER)
(360) 907-7534
Entity
Organization

Contact information

Practice address
3030 WARRENVILLE RD STE 210, LISLE, IL 60532-3646
(872) 215-0361
(877) 384-2623
Mailing address
2641 HADDASSAH DR, NAPERVILLE, IL 60565-3067
(872) 215-0361
(877) 384-2623

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
207RP1001X
Pulmonary Disease Physician
207Y00000X
Otolaryngology Physician
207YS0012X
Sleep Medicine (Otolaryngology) Physician
2084S0012X
Sleep Medicine (Psychiatry & Neurology) Physician

Other

Enumeration date
05/02/2024
Last updated
06/23/2025
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