Glen Coulomb is a Vascular Surgery in Lombard, Illinois. Glen Coulomb practices all healthcare services and medical treatments related to Vascular Surgery. The NPI Number for Glen Coulomb is 1396705489. The last update date is 2011-02-22.
Glen Coulomb's current location address is 1919 S Highland Ave, Lombard, Illinois. You can contact this provider via phone number 6308737305 and fax number 6304163189. The mailing address for Glen Coulomb is 1919 S Highland Ave, Lombard, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Glen Coulomb |
|---|---|
| Address | 1919 S Highland Ave, Lombard, Illinois |
| Phone Number | 6308737305 |
| Fax Number | 6304163189 |
| Sole Proprietor | N |
| Credentials | MD |
NPI Number Detail
| NPI Number | 1396705489 |
|---|---|
| Provider Enumeration Date | 2006-03-24 |
| Last Updated Date | 2011-02-22 |
Provider Mailing Address Detail
| Address | 1919 S Highland Ave |
|---|---|
| City | Lombard |
| State | Illinois (IL) |
| Post Code | 601486153 |
| Phone Number | 6308737305 |
| Fax Number | 6304163189 |
Provider's Primary Taxonomy Detail
| Speciality | Vascular Surgery |
|---|---|
| Taxonomy | 2086S0129X |
| Licence No | 36063012 |
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Definition: A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 2215038 | IL | BLUE CROSS BLUE SHIELD |
Post Comment/ Review Below
What is the unique identifier code issued to Glen Coulomb by the Centers for Medicare & Medicaid Services (CMS)?
The Glen Coulomb has been assigned the NPI (National Provider Identifier) 1396705489. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Could you share the physical location details of Glen Coulomb?
The Glen Coulomb is situated at 1919 S Highland Ave, in the city of Lombard, state of IL, with the zip code 601486153.
What is Glen Coulomb's specialized field of practice, and what is the corresponding taxonomy classification code?
The Glen Coulomb's area of specialization is Vascular Surgery, and the corresponding taxonomy code that categorizes this field of practice is 2086S0129X.
On what date did the Centers for Medicare & Medicaid Services issue the 1396705489 to Glen Coulomb?
The Glen Coulomb received its 1396705489 assignment from the Centers for Medicare & Medicaid Services on 2006-03-24.
When was the Glen Coulomb's information last updated?
The Glen Coulomb's information was last updated on 2011-02-22.