MEDICARE: GLAMMURE AESTHETICS PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LG0600X	Gerontology Nurse Practitioner

General Provider Information

NPI Number	:	1043145170
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GLAMMURE AESTHETICS PLLC

Provider Business Mailing Address
First Line	:	1281 KEIM TRL
Second Line	:
City	:	BARTLETT
State	:	IL
Zip	:	60103-7507
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1281 KEIM TRL
Second Line	:
City	:	BARTLETT
State	:	IL
Zip	:	60103-7507
Country	:	US
Telephone Number	:	224-325-4860
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JANICE COLON
Credential	:	NP
Telephone Number	:	630-313-0829

Provider Enumeration Date	:	06/18/2026
Last Update Date	:	06/24/2026

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