Provider Demographics
NPI:1326030461
Name:GLASS-SHERMAN, LATOYA NASHAGE (DC)
Entity Type:Individual
Prefix:DR
First Name:LATOYA
Middle Name:NASHAGE
Last Name:GLASS-SHERMAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4023 183RD ST
Mailing Address - Street 2:
Mailing Address - City:COUNTRY CLUB HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60478-5306
Mailing Address - Country:US
Mailing Address - Phone:708-799-7855
Mailing Address - Fax:708-799-7866
Practice Address - Street 1:4023 183RD ST
Practice Address - Street 2:
Practice Address - City:COUNTRY CLUB HILLS
Practice Address - State:IL
Practice Address - Zip Code:60478-5306
Practice Address - Country:US
Practice Address - Phone:708-799-7855
Practice Address - Fax:708-799-7866
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-16
Last Update Date:2014-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-010238111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor