Fondren, Glen Sekou

Fondren, Glen Sekou is an individual health care provider with primary practice located at 1414 Main St , Melrose Park IL 60160-3902. He recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as his primary health care specialty. Fondren, Glen Sekou can be contacted via phone (708) 681-0073.

Contact Information

Primary practice address
1414 Main St Melrose Park IL 60160-3902
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X

Profile Details

NPI number 1275801110
LBN Legal business name Fondren, Glen Sekou
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 7th, 2011
Last updated Dec 7th, 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.

Request for update

Popular Providers