Provider Demographics
NPI:1881691863
Name:GLASER, SCOTT E (MD)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:E
Last Name:GLASER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:7055 HIGH GROVE BLVD
Mailing Address - Street 2:
Mailing Address - City:BURR RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60527-7593
Mailing Address - Country:US
Mailing Address - Phone:630-371-9980
Mailing Address - Fax:630-371-9983
Practice Address - Street 1:7055 HIGH GROVE BLVD
Practice Address - Street 2:
Practice Address - City:BURR RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60527-7593
Practice Address - Country:US
Practice Address - Phone:630-371-9980
Practice Address - Fax:630-371-9983
Is Sole Proprietor?:No
Enumeration Date:2005-07-05
Last Update Date:2014-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036078362207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036078362Medicaid