Gladson, Marina
Gladson, Marina is an sole proprietor health care provider with primary practice located at 525 E Congress Pkwy Ste 350 , Crystal Lake IL 60014-6271. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Gladson, Marina can be contacted via phone (815) 479-7490.Contact Information
Primary practice address
525 E Congress Pkwy Ste 350
Crystal Lake IL 60014-6271
Phone: (815) 479-7490
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 036116018 | Illinois |
Profile Details
| NPI number | 1588751366 |
|---|---|
| LBN Legal business name | Gladson, Marina |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 5th, 2006 |
| Last updated | May 1st, 2024 - about 6 months 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 | 1588751366 | NPPES |
| Illinois | MEDICAID | 036116018 |
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