Individual
TERRENCE GLENNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
201 S 14TH ST, HERRIN, IL 62948-3631
(618) 942-2171
(618) 351-4846
Mailing address
PO BOX 3988, CARBONDALE, IL 62902-3988
(618) 457-5200
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
036077232
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036077232
—
IL
01
—
344609407-00
BWC OHIO
—
Enumeration date
08/08/2006
Last updated
10/01/2025
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