Active NPI
Glorinda Conley Henry
- Health Educator
- Country Club Hills, IL
National Provider Identifier
1265841746
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health Educator
- License
- 2013779
- Practice address
- 4131 W. 192ND PL.
Country Club Hills, IL 60478 - Phone
- (708) 957-1391
- NPI assigned
- Aug 8, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health Educator | 174H00000X | 2013779 | IL | Primary |
Addresses
Primary practice location
4131 W. 192ND PL.
Country Club Hills, IL 60478
Mailing address
4131 W. 192ND PL.
Country Club Hills, IL 60478
Phone (708) 957-1391
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 358264862B6 | Other | IL | MEDICARE HEALTH INSURANCE |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2013779 | IL | MD | Health Educator |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1407456000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1407456000000",
"number": "1265841746",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4131 W. 192ND PL.",
"city": "COUNTRY CLUB HILLS",
"state": "IL",
"postal_code": "60478",
"telephone_number": "708-957-1391"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4131 W. 192ND PL.",
"city": "COUNTRY CLUB HILLS",
"state": "IL",
"postal_code": "60478",
"telephone_number": "708-957-1391"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENRY",
"first_name": "GLORINDA",
"middle_name": "CONLEY",
"name_prefix": "Miss",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-08-08",
"last_updated": "2014-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "174H00000X",
"taxonomy_group": "",
"desc": "Health Educator",
"state": "IL",
"license": "2013779",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE HEALTH INSURANCE",
"identifier": "358264862B6",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Country Club Hills, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.