Individual
DR. ETHAN PHARES GLASER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD, PHD
Contact information
Practice address
5841 S MARYLAND AVE STE MC7082, CHICAGO, IL 60637-1465
(773) 702-6840
Mailing address
180 HARVESTER DR STE 110, BURR RIDGE, IL 60527-6686
(773) 702-1150
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
125085584
IL
Other
Enumeration date
04/02/2025
Last updated
05/21/2025
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