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NPI Code Detail

MEDICARE: ARI DEAN GLECKMAN PHD

MEDICARE:   ARI DEAN GLECKMAN  PHD
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
1103TC0700XClinical Psychologist20041012IN

Other Identifiers

General Provider Information

NPI Number : 1437145786
Entity Type Code : Individual
Provider Name (Legal Business Name) : ARI DEAN GLECKMAN PHD
Provider Business Mailing Address
First Line : 29943 NETWORK PL
Second Line :
City : CHICAGO
State : IL
Zip : 60673-1299
Country : US
Telephone Number : 317-706-3415
Fax Number : 317-706-3417
Provider Business Practice Location Address
First Line : 8805 N MERIDIAN ST STE 200
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46260-2643
Country : US
Telephone Number : 317-706-7246
Fax Number : 317-706-3417
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/22/2005
Last Update Date : 12/01/2025

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