Provider Demographics
NPI:1801447180
Name:GLAUSER, TAMMY RENEE (RN)
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:RENEE
Last Name:GLAUSER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12865 W CLARENDON RD
Mailing Address - Street 2:
Mailing Address - City:BEACH PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60099-9646
Mailing Address - Country:US
Mailing Address - Phone:224-381-3383
Mailing Address - Fax:
Practice Address - Street 1:2216 20TH ST
Practice Address - Street 2:
Practice Address - City:ZION
Practice Address - State:IL
Practice Address - Zip Code:60099-1648
Practice Address - Country:US
Practice Address - Phone:847-445-4633
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-27
Last Update Date:2019-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041308133163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse