Sidler, Glen J
Sidler, Glen J is an sole proprietor health care provider with primary practice located at 201 N Cummings Ln , Washington IL 61571-2181. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Sidler, Glen J can be contacted via phone (309) 444-2005.Contact Information
Primary practice address
201 N Cummings Ln
Washington IL 61571-2181
Phone: (309) 444-2005
Fax: (309) 444-2006
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 036060332 | Illinois |
Profile Details
| NPI number | 1043298557 |
|---|---|
| LBN Legal business name | Sidler, Glen J |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 4th, 2006 |
| Last updated | Oct 29th, 2014 - about 12 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 | 1043298557 | NPPES |
| Illinois | Other | 1043298557 | NPI |
| Illinois | MEDICAID | 036060332 | NPI |
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