NPIMap

Organization Active NPI

Glenwood Center LTD

  • Psychiatry Physician
  • Rockford, IL
National Provider Identifier
1003033861
Registry record updated Jan 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
GLENWOOD CENTER LTD
Practice address
2823 Glenwood Ave
Rockford, IL 61101-3542
Phone
(815) 968-5342
Fax
(815) 968-4656
NPI assigned
Apr 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Frank Eugene Cushing, ED. DNPI 1013055144
Title
President
Phone
(815) 968-5342

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

2823 Glenwood Ave
Rockford, IL 61101-3542

Mailing address

2823 Glenwood Ave
Rockford, IL 61101-3542
Phone (815) 968-5342

Other names 1

  • GLENWOOD BUILDING GROUP LTD Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071214000734 IL Part B Supplier - Clinic/Group Practice 2567552441 Receives reassigned benefits from 3 practitioners
Practice locations: Rockford, IL

National Provider Directory

National Provider Directory

Locations

2721 Glenwood Ct
Rockford, IL 61101
Phone (815) 968-5342

Practitioners & affiliated clinicians

Practitioners 22

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 22

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199318400000",
    "number": "1003033861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2823 GLENWOOD AVE",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611013542",
            "telephone_number": "815-968-5342",
            "fax_number": "815-968-4656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2823 GLENWOOD AVE",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611013542",
            "telephone_number": "815-968-5342",
            "fax_number": "815-968-4656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENWOOD CENTER LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-20",
        "last_updated": "2008-01-03",
        "status": "A",
        "authorized_official_last_name": "CUSHING",
        "authorized_official_first_name": "FRANK",
        "authorized_official_middle_name": "EUGENE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "815-968-5342",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "ED. D"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GLENWOOD BUILDING GROUP LTD",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Rockford, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.