Healthcare Provider Details

I. General information

NPI: 1942602461
Provider Name (Legal Business Name): DANIEL GLON NP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2014
Last Update Date: 05/06/2025
Certification Date: 05/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

332 S MICHIGAN AVE STE 900
CHICAGO IL
60604-4393
US

IV. Provider business mailing address

1775 BALLARD ROAD, ADVOCATE MEDICAL GROUP
PARK RIDGE IL
60068
US

V. Phone/Fax

Practice location:
  • Phone: 855-229-2191
  • Fax:
Mailing address:
  • Phone: 847-318-2500
  • Fax: 847-318-2558

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209011850
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: