Glick, Melvin I
Glick, Melvin I is an sole proprietor health care provider with primary practice located at 4475 Lawn Ave , Western Springs IL 60558-1283. He recently has only one registered license in Allopathic & Osteopathic Physicians / Geriatric Medicine, which is considered as his primary health care specialty. Glick, Melvin I can be contacted via phone (708) 246-2500.Contact Information
Primary practice address
4475 Lawn Ave
Western Springs IL 60558-1283
Phone: (708) 246-2500
Fax: (708) 246-2785
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Geriatric Medicine | 207QG0300X | 036057005 | Illinois |
Profile Details
| NPI number | 1124136601 |
|---|---|
| LBN Legal business name | Glick, Melvin I |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 26th, 2006 |
| Last updated | Jun 29th, 2010 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1124136601 | NPPES |
| Illinois | Other | 21628146 | BCBS |
| Illinois | Other | 080162189 | BCBS |
| Illinois | Other | 570740 | BCBS |
| Illinois | MEDICAID | 036057005 | BCBS |
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