Healthcare Provider Details

I. General information

NPI: 1811272248
Provider Name (Legal Business Name): THE GLOCOMS GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2011
Last Update Date: 10/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 E CHICAGO AVE # 200
CHICAGO IL
60611-2026
US

IV. Provider business mailing address

1400 W FULTON ST
CHICAGO IL
60607-1110
US

V. Phone/Fax

Practice location:
  • Phone: 312-456-0991
  • Fax: 312-949-9139
Mailing address:
  • Phone: 312-456-0991
  • Fax: 312-949-9139

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License Number
License Number State

VIII. Authorized Official

Name: DR. MAURENCE ANGUH
Title or Position: CHAIRMAN & CEO
Credential:
Phone: 312-456-0991