Individual
DR. GLEN N FEATHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
180 S MAIN ST, CANTON, IL 61520-2608
(309) 647-0201
(309) 649-6880
Mailing address
2907 W WARDCLIFFE DR, PEORIA, IL 61604-2157
(309) 404-1914
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
036079920
IL
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
036079920
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036079920
—
IL
Enumeration date
10/21/2005
Last updated
11/18/2019
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