Basic Information
| Provider Information | |||||||||
| NPI: | 1104863406 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GOLBUS | ||||||||
| FirstName: | GLENN | ||||||||
| MiddleName: | ALAN | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1919 S HIGHLAND AVE | ||||||||
| Address2: | SUITE B202 ATTN JAN LEWIS | ||||||||
| City: | LOMBARD | ||||||||
| State: | IL | ||||||||
| PostalCode: | 601486153 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6302681102 | ||||||||
| FaxNumber: | 6302681125 | ||||||||
| Practice Location | |||||||||
| Address1: | 1555 BARRINGTON RD | ||||||||
| Address2: | BLDG 3 SUITE 3200 | ||||||||
| City: | HOFFMAN ESTATES | ||||||||
| State: | IL | ||||||||
| PostalCode: | 601941018 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8478828448 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/02/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RI0011X | IL | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology |
No ID Information.