Coulomb, Glen
Coulomb, Glen is an individual health care provider with primary practice located at 801 S Washington St , Naperville IL 60540-7430. He recently has only one registered license in Allopathic & Osteopathic Physicians / Vascular Surgery, which is considered as his primary health care specialty. Coulomb, Glen can be contacted via phone (630) 281-2670.Contact Information
Primary practice address
801 S Washington St
Naperville IL 60540-7430
Phone: (630) 281-2670
Fax: (815) 327-2475
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Vascular Surgery | 2086S0129X | 036063012 | Illinois |
Profile Details
| NPI number | 1396705489 |
|---|---|
| LBN Legal business name | Coulomb, Glen |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 24th, 2006 |
| Last updated | Feb 22nd, 2011 - about 13 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 | 1396705489 | NPPES |
| Illinois | Other | 02215038 | BLUE CROSS BLUE SHIELD |
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