Individual
ROBERT S. GLICKENBERGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
751 N RUTLEDGE ST STE 1100, SPRINGFIELD, IL 62702-4968
(217) 545-8000
(217) 545-4735
Mailing address
PO BOX 19636, SPRINGFIELD, IL 62794-9636
(217) 545-8000
(217) 545-4735
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
036-107050
IL
207RG0100X
Gastroenterology Physician
Primary
036107050
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036-107050
IL LICNESE
IL
Enumeration date
08/30/2006
Last updated
03/17/2018
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