Provider Demographics
NPI:1437307212
Name:SCHWEITZER, GLENN STEVEN (DDS)
Entity type:Individual
Prefix:DR
First Name:GLENN
Middle Name:STEVEN
Last Name:SCHWEITZER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:GLENN
Other - Middle Name:WILLARD
Other - Last Name:SCHWEITZER
Other - Suffix:JR
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:503 THORNHILL DRIVE
Mailing Address - Street 2:
Mailing Address - City:CAROL STREAM
Mailing Address - State:IL
Mailing Address - Zip Code:60188-2780
Mailing Address - Country:US
Mailing Address - Phone:630-653-0020
Mailing Address - Fax:630-653-0146
Practice Address - Street 1:503 THORNHILL DRIVE
Practice Address - Street 2:
Practice Address - City:CAROL STREAM
Practice Address - State:IL
Practice Address - Zip Code:60188-2780
Practice Address - Country:US
Practice Address - Phone:630-653-0020
Practice Address - Fax:630-653-0146
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-04
Last Update Date:2008-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190134521223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice