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Individual

DR. GLENN SKOW

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D., MPH, FAAFP

Contact information

Practice address
650 W TAYLOR ST, VANDALIA, IL 62471-1227
(618) 283-5136
Mailing address
825 NEW YORK DR STE 2, VANDALIA, IL 62471-1044
(618) 283-5545

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036130323
IL
207Q00000X
Family Medicine Physician
036130323
IL
207Q00000X
Family Medicine Physician
258929
NY

Other

Enumeration date
03/27/2009
Last updated
02/06/2025
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