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1275517013
GLENN C HENRIKSON
OAK LAWN, IL
NPI
1275517013
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2085R0202X Radiology, Diagnostic Radiology
(Licence: IL 036063101)
Enumeration Date
2005-12-05
Last Update Date
2008-05-27
Business Address
-- GLENN C HENRIKSON DO
4440 W 95TH ST
OAK LAWN, IL 60453-2600
Phone number: 708-684-5520
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Mailing Address
-- GLENN C HENRIKSON DO
541 OTIS BOWEN DR
MUNSTER, IN 46321-4158
Phone number:
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