Individual
MEGAN LESLEY GLENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C.
Contact information
Practice address
3024 E EMPIRE ST STE EANDF, BLOOMINGTON, IL 61704-5402
(309) 451-3376
(309) 452-3376
Mailing address
1820 SALTONSTALL DR, NORMAL, IL 61761-9354
(630) 247-8497
(309) 624-8820
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085.004236
IL
Other
Enumeration date
01/04/2012
Last updated
03/13/2023
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