Kueltzo, Glenn D.

Kueltzo, Glenn D. is an individual health care provider with primary practice located at 13231 W 143Rd St Suite 101, Homer Glen IL 60491-6638. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Kueltzo, Glenn D. can be contacted via phone (708) 301-2020.

Contact Information

Primary practice address
13231 W 143Rd St Suite 101 Homer Glen IL 60491-6638
Phone: (708) 301-2020
Fax: (708) 301-0884
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X Illinois

Profile Details

NPI number 1740290386
LBN Legal business name Kueltzo, Glenn D.
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 8th, 2006
Last updated Aug 31st, 2007 - about 17 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1740290386 NPPES
Illinois Other 0039940592 BCBS OF ILLINOIS

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