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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. JONATHAN SHANE GLICKSTEIN, MD

Active

DR. JONATHAN SHANE GLICKSTEIN, MD is a Otolaryngology healthcare provider located in GIBSON CITY, Illinois. NPI 1598983371 is currently active in the NPPES registry. Verify at CMS.

Otolaryngology · GIBSON CITY, IL

Registration Details

NPI Number
1598983371
Provider Type
Individual
Gender
Male
NPI Issued
Apr 24, 2007 (19.352112128686 yrs)
Last Updated
Mar 22, 2021
Licenses
49523 (MN)
036.154865 (IL)

Practice Information

Address
1120 N MELVIN ST
GIBSON CITY, IL, 609361477
Browse IL providers · Browse ZIP 60936
Phone
2177842212
Primary Specialty
Otolaryngology
207Y00000X
Additional Specialty
Otolaryngology
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.