1497763569 NPI number — MR. ROBERT SAUL GLASER MSW. LCSW

Table of content: MR. ROBERT SAUL GLASER MSW. LCSW (NPI 1497763569)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497763569 NPI number — MR. ROBERT SAUL GLASER MSW. LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GLASER
Provider First Name:
ROBERT
Provider Middle Name:
SAUL
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
MSW. LCSW
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1497763569
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2835 N SHEFFIELD AVE
Provider Second Line Business Mailing Address:
SUITE 402
Provider Business Mailing Address City Name:
CHICAGO
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60657-5081
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
773-880-8815
Provider Business Mailing Address Fax Number:
773-281-3429

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2835 N SHEFFIELD AVE
Provider Second Line Business Practice Location Address:
SUITE 402
Provider Business Practice Location Address City Name:
CHICAGO
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60657-5081
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
773-880-8815
Provider Business Practice Location Address Fax Number:
773-281-3429
Provider Enumeration Date:
08/04/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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