Individual
MICHELE THERESE GLASGOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2111 MIDLANDS CT, SYCAMORE, IL 60178-3125
(815) 758-0000
(815) 756-7130
Mailing address
2111 MIDLANDS CT, SYCAMORE, IL 60178-3125
(815) 758-0000
(815) 756-7130
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
036-089790
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
011569
HEALTH ALLIANCE
IL
01
—
01915167
BLUE CROSS/BLUE SHIELD
IL
01
—
0359580001
DMERC
IL
05
—
036089790
—
IL
01
—
200020667
RAILROAD MEDICARE
IL
Enumeration date
08/20/2006
Last updated
10/02/2020
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