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Jorell Glass
Prosthetics Case Management in Peoria, Illinois
NPI 1508421579

Jorell Glass is a Prosthetics Case Management based in Peoria, IL and is specialized in Prosthetics Case Management. Jorell Glass practices in Peoria, IL. The NPI Number for Jorell Glass is 1508421579 and holds a License No. (Illinois).

The current practice location address for Jorell Glass is 456 Fulton St Ste 180, Peoria, IL and can be reached out via phone at 309-408-9399.

Location: 456 Fulton St Ste 180, Peoria, IL, 61604-2548
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1508421579
Provider Name
Jorell Glass
Credential
Provider Entity Type
Individual
Gender
Male
Address
456 Fulton St Ste 180, Peoria, IL, 61604-2548
Phone Number
309-408-9399
Fax Number
Provider Enumeration Date
05/06/2019
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1744P3200X 01 IL CERTIFIED HAIR LOSS SPECIALIST
institution
Provider Business Practice Location Address Details
Address
456 Fulton St Ste 180
City
Peoria
State
Illinois
Zip
61602-1292
Phone Number
309-408-9399
Fax Number
person
Provider Business Mailing Address Details
Address
456 Fulton St Ste 180
City
Peoria
State
Illinois
Zip
61602-1292
Phone Number
309-408-9399
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
Prosthetics Case Management
Taxonomy
1744P3200X
License No.
()
Definition
Definition to come...
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