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Contact Information

MARK GLASSON
7719 BRIDLEWOOD RD
CALEDONIA, IL61011-9011
 Phone: 815-222-9242
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Registered Nurse First Assistant

163WR0006X
Indicates primary specialty

NPI Profile & details for MARK GLASSON · (Male)

NPI Number 1164287686
Status Active
Credentials
Entity Individual
Enumeration date 02/14/2024
Last updated 02/14/2024 - About 2 years ago
Sole proprietor 1 Yes
Identifiers
  • IL License # 041249330
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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