Individual
DR. MARK JOHN GLESENER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1750 E MAIN ST, SUITE #60, ST CHARLES, IL 60174-2363
(630) 377-8844
(630) 377-8404
Mailing address
1750 E MAIN ST, SUITE #60, ST CHARLES, IL 60174-2363
(630) 377-8844
(630) 377-8404
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038-006085
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04532055
BLUE CROSS BLUE SHIELD #
IL
Enumeration date
08/10/2005
Last updated
01/05/2021
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