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General NPI Number Information
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NPI Number | 1811272248
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Entity Type | Organization
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Legal Business Name | THE GLOCOMS GROUP INC
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Dates
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Enumeration Date | 10/17/2011
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Last Update Date | 10/17/2011
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Provider Practice Location Address
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Address Line | 40 E CHICAGO AVE # 200
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City | CHICAGO
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State | IL
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Zip | 60611-2026
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Country | US
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Telephone | 312-456-0991
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Fax | 312-949-9139
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Provider Business Mailing Address
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Address Line | 1400 W FULTON ST
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City | CHICAGO
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State | IL
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Zip | 60607-1110
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Country | US
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Telephone | 312-456-0991
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Fax | 312-949-9139
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Authorized Official
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Title or Position | CHAIRMAN & CEO
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Name | DR. MAURENCE ANGUH
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Credential |
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Telephone | 312-456-0991
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302F00000X
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Taxonomy Name | Exclusive Provider Organization
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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License Number |
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License Number State |
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