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NPI Code Detail

MEDICARE: MS. DIANA M GLAB APN-CRNA

MEDICARE: MS. DIANA M GLAB APN-CRNA
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
1367500000XCertified Registered Nurse Anesthetist209028001IL

General Provider Information

NPI Number : 1053089532
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. DIANA M GLAB APN-CRNA
Provider Business Mailing Address
First Line : 2650 RIDGE AVE STE 1223
Second Line :
City : EVANSTON
State : IL
Zip : 60201-1700
Country : US
Telephone Number : 847-982-3172
Fax Number :
Provider Business Practice Location Address
First Line : 800 W CENTRAL RD
Second Line :
City : ARLINGTON HEIGHTS
State : IL
Zip : 60005-2349
Country : US
Telephone Number : 478-618-7140
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2021
Last Update Date : 01/23/2026

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