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General NPI Number Information
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NPI Number | 1023136595
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Entity Type | Individual
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Provider Name | GLENDA G EDWARDS DC
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Gender | Female
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 18W265 73RD STREET
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City | DARIEN
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State | IL
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Zip | 60561-3767
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Country | US
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Telephone | 630-964-4127
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Fax | 630-964-4535
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Provider Business Mailing Address
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Address Line | 18W265 73RD STREET
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City | DARIEN
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State | IL
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Zip | 60561-3767
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Country | US
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Telephone | 630-964-4127
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Fax | 630-964-4535
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State | IL
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