Individual
DR. BERNARD GLOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
3033 OGDEN AVE, LEGACY CLINICAL CONSULTANTS SUITE 210, LISLE, IL 60532-1673
(630) 527-1664
Mailing address
5703 S CASS AVE APT 213, WESTMONT, IL 60559-3283
(603) 963-5699
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
—
103TC0700X
Clinical Psychologist
Primary
071-003497
IL
Other
Enumeration date
01/19/2007
Last updated
02/02/2010
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