Individual
GLENN F CARLSON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
717 N WAIOLA AVE, LA GRANGE PARK, IL 60526-1451
(610) 563-7515
Mailing address
717 N WAIOLA AVE, LA GRANGE PARK, IL 60526-1451
(610) 563-7515
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036.073913
IL
Other
Enumeration date
08/07/2025
Last updated
08/07/2025
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