Healthcare Provider Details

I. General information

NPI: 1366975369
Provider Name (Legal Business Name): GABRIELLA D COZZI-GLASER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: GABRIELLA COZZI MD

II. Dates (important events)

Enumeration Date: 04/06/2017
Last Update Date: 01/08/2025
Certification Date: 01/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

675 N SAINT CLAIR ST STE 14-200
CHICAGO IL
60611-5966
US

IV. Provider business mailing address

1717 6TH AVE S
BIRMINGHAM AL
35233-1801
US

V. Phone/Fax

Practice location:
  • Phone: 312-695-7542
  • Fax: 312-695-5462
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number37653
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number036169682
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: