Individual
DR. GLENN GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3815 HIGHLAND AVE, DOWNERS GROVE, IL 60515-1500
(630) 275-5900
Mailing address
185 PENNY AVE, EAST DUNDEE, IL 60118-1454
(847) 836-7015
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
036069959
IL
208VP0014X
Interventional Pain Medicine Physician
036069959
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036069959
—
IL
Enumeration date
05/19/2006
Last updated
12/31/2021
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