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Individual

MARINA GLADSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
525 E CONGRESS PKWY STE 350, CRYSTAL LAKE, IL 60014-6271
(815) 479-7490
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1293

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036116018
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036116018
IL
Enumeration date
10/05/2006
Last updated
05/01/2024
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