Individual
LUCILLE CLAIRE GLENN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
500 E 51ST ST STE 1, CHICAGO, IL 60615-2494
(312) 572-1719
Mailing address
1221 E COOPER DR, PALATINE, IL 60074-7285
(847) 999-8098
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085010932
IL
Other
Enumeration date
01/16/2025
Last updated
01/16/2025
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