DR. Glen L Ricca, M.D.

NPI #1730134073 in Streator, Illinois

Provider Information

NPI Number: 1730134073
Entity Type: Individual
Name: DR. Glen L Ricca, M.D.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Family Medicine
Credential: M.D.
Enumeration Date: May 24, 2006
Last Updated: Mar 10, 2011

Practice Location

Address: 109 E ELM ST
City: Streator
State: Illinois
ZIP Code: 61364-2223
Phone: (815) 672-4587

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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