Healthcare Provider Details

I. General information

NPI: 1104873124
Provider Name (Legal Business Name): GLENN P. ZEMEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2006
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 S WASHINGTON ST
NAPERVILLE IL
60540-7430
US

IV. Provider business mailing address

387 SHUMAN BLVD STE 240W
NAPERVILLE IL
60563-8113
US

V. Phone/Fax

Practice location:
  • Phone: 630-355-0450
  • Fax:
Mailing address:
  • Phone: 630-355-0450
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number036108942
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number036108942
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number102117-875
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: