Glen Lake Psychological Services, LTD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

071001664 Issued in IL

Legal business name

GLEN LAKE PSYCHOLOGICAL SERVICES, LTD

Practice address

1701 E Lake Ave
Suite #370
Glenview, IL 60025-2065

Phone

(847) 657-9600

Fax

(847) 998-8042

NPI assigned

Apr 27, 2016

Organization subpart

No

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

Authorized official

Name

James Fruehling, PHD

Title

Owner

Phone

(847) 670-0880

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Rosemary Whittle Egan, PH.D.

  • Professional Counselor
  • Glenview, IL
  • NPI 1508033002
  NPD (past)

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

{
    "created_epoch": "1461715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462147200000",
    "number": "1104271162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 E LAKE AVE",
            "address_2": "SUITE #370",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600252065",
            "telephone_number": "847-657-9600",
            "fax_number": "847-998-8042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 E LAKE AVE",
            "address_2": "SUITE #370",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600252065",
            "telephone_number": "847-657-9600",
            "fax_number": "847-998-8042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLEN LAKE PSYCHOLOGICAL SERVICES, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-27",
        "last_updated": "2016-05-02",
        "status": "A",
        "authorized_official_last_name": "FRUEHLING",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-670-0880",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "IL",
            "license": "071001664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lina Gladish, M.D.
• Alexander Paul Glaser, MD
• Shanna Glasstetter, OTR/L
• Andrea Rose Gleason, DPT
• Glen Endoscopy Center, LLC
• Glen Medical Associates SC (Thomas Ficho, M.D., Ph.D.)
• Glen Perio
• Glen Ridge Associates II Limited Partnership (The Abingtonof Glenview)
• Glenbrook Family Dental
• Glenbrook Oral & Maxillofacial Surgery LTD

• Psychologist in Glenview, IL
• Providers in Glenview, IL by specialty
• Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.