Glass, Jorell
Glass, Jorell is an sole proprietor health care provider with primary practice located at 456 Fulton St Ste 180 , Peoria IL 61602-1292. He recently has only one registered license in Other Service Providers / Prosthetics Case Management, which is considered as his primary health care specialty. Glass, Jorell can be contacted via phone (309) 408-9399.Contact Information
Primary practice address
456 Fulton St Ste 180
Peoria IL 61602-1292
Phone: (309) 408-9399
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Prosthetics Case Management | 1744P3200X |
Profile Details
| NPI number | 1508421579 |
|---|---|
| LBN Legal business name | Glass, Jorell |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 6th, 2019 |
| Last updated | May 6th, 2019 - about 5 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 | 1508421579 | NPPES |
| Illinois | Other | 1744P3200X | CERTIFIED HAIR LOSS SPECIALIST |
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