Organization
EARL G GLOECKNER, M.D., LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EARL G GLOECKNER M.D. (PRESIDENT)
(309) 762-2333
Entity
Organization
Contact information
Practice address
1420 7TH ST, MOLINE, IL 61265-2916
(309) 762-2333
(309) 762-8001
Mailing address
1420 7TH ST, MOLINE, IL 61265-2916
(309) 762-2333
(309) 762-8001
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08100437
BLUE CROSS BLUE SHIELD
IL
Enumeration date
04/12/2007
Last updated
03/25/2008
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