Glennetta Coleman MD and Associates, LTD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

GLENNETTA COLEMAN MD AND ASSOCIATES, LTD

Practice address

1983 Daimler Road
Rockford, IL 61112-1081

Phone

(815) 227-0055

Fax

(815) 227-0050

NPI assigned

Jun 14, 2006

Last updated

Aug 6, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tricia Olagues, RN

Title

Practice Manager

Phone

(815) 227-0055

Specialties & licenses 2

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722902400000",
    "number": "1184667438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1893 DAIMLER RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611121081",
            "telephone_number": "815-227-0055",
            "fax_number": "815-227-0050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1983 DAIMLER ROAD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611121081",
            "telephone_number": "815-227-0055",
            "fax_number": "815-227-0050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENNETTA COLEMAN MD AND ASSOCIATES, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-14",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-06",
        "status": "A",
        "authorized_official_last_name": "OLAGUES",
        "authorized_official_first_name": "TRICIA",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "815-227-0055",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036-06741",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF ILLINOIS",
            "identifier": "0031603167",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephen F. Gladdin, M.D.
• Glaucoma Associates of Illinois LLC
• Tyler Glawe, PT, DPT
• Tara Glendenning, OTR/L
• Vanessa M Glendenning, FNP
• Glenwood Center LTD
• Dejana Gligorevic, DOCTOR OF PHARMACY
• Global Dental Center Inc
• Global Imaging Institute
• Cristina Gloria, LCPC

• Internal Medicine Physician in Rockford, IL
• Providers in Rockford, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2024; 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.