Individual
WAYNE R GLAD
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
900 N WESTMORELAND RD, STE LL70, LAKE FOREST, IL 60045-1674
(847) 295-0340
(847) 295-0351
Mailing address
900WW NORTH SHORE DR 160, LAKE BLUFF, IL 60044-2218
(847) 295-0340
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
071002465
IL
Other
Enumeration date
11/15/2005
Last updated
07/05/2016
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