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NPI Code Detail

MEDICARE: KATHRYN MARIE GLYNN M.D.

MEDICARE:   KATHRYN MARIE GLYNN  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208VP0014XInterventional Pain Medicine Physician60823734WA
2208VP0014XInterventional Pain Medicine Physician18509NV
3207L00000XAnesthesiology Physician036119191IL
4208VP0014XInterventional Pain Medicine Physician1625WI

Other Identifiers

General Provider Information

NPI Number : 1235143793
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHRYN MARIE GLYNN M.D.
Provider Business Mailing Address
First Line : PO BOX 735044
Second Line :
City : CHICAGO
State : IL
Zip : 60673-5044
Country : US
Telephone Number : 800-326-2250
Fax Number :
Provider Business Practice Location Address
First Line : 700 N WESTHAVEN DR
Second Line :
City : OSHKOSH
State : WI
Zip : 54904-6947
Country : US
Telephone Number : 920-303-8700
Fax Number : 920-456-5590
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2006
Last Update Date : 10/29/2025

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