Individual
DR. JASON SCOTT GLICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2942 CENTRAL ST, EVANSTON, IL 60201-1246
(847) 905-0555
Mailing address
2942 CENTRAL ST, EVANSTON, IL 60201-1246
(847) 905-0555
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
021.002285
IL
1223P0221X
Pediatric Dentistry
Primary
021002285
IL
1223P0221X
Pediatric Dentistry
FAC-40237
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
021.002285
STATE OF ILLINOIS
IL
01
—
050551
NEW YORK STATE DENTAL LICENSE
NY
01
—
2901022932
STATE OF MICHIGAN
MI
01
—
FAC-40237
IOWA DENTAL BOARD
IA
Enumeration date
10/25/2006
Last updated
06/20/2025
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