Organization
ROBERT S GLICK DPM PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT S GLICK DPM (PRESIDENT)
(312) 243-3131
Entity
Organization
Contact information
Practice address
1630 W 18TH ST, CHICAGO, IL 60608-2817
(312) 243-3131
Mailing address
1630 W 18TH ST, CHICAGO, IL 60608-2817
(312) 243-3131
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
016002695
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0527240001
NATIONAL SUPPLIER ID
—
Enumeration date
02/02/2007
Last updated
08/15/2013
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