Individual provider Active NPI

Glendolyn Spencer

  • Attendant Care Provider
  • South Holland, IL
National Provider Identifier
1154976827
Registry record updated Aug 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Attendant Care ProviderTaxonomy code 3747A0650X
Practice address
752 E 163Rd PL
South Holland, IL 60473-2305
Phone
(630) 337-2743
NPI assigned
Aug 8, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Attendant Care Provider 3747A0650X Primary

Addresses

Primary practice location

752 E 163Rd PL
South Holland, IL 60473-2305

Mailing address

752 E 163Rd PL
South Holland, IL 60473-2305
Phone (630) 337-2743

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1565222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565222400000",
    "number": "1154976827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "752 E 163RD PL",
            "city": "SOUTH HOLLAND",
            "state": "IL",
            "postal_code": "604732305",
            "telephone_number": "630-337-2743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "752 E 163RD PL",
            "city": "SOUTH HOLLAND",
            "state": "IL",
            "postal_code": "604732305",
            "telephone_number": "630-337-2743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "GLENDOLYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-08",
        "last_updated": "2019-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747A0650X",
            "taxonomy_group": "",
            "desc": "Technician, Attendant Care Provider",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Holland, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2019; 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.