Active NPI
Marian Glenn
- Psychiatric/Mental Health Nurse Practitioner
- Lombard, IL
National Provider Identifier
1265858013
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 209.011113
- Practice address
- 2340 S Highland Ave
Suite 300
Lombard, IL 60148-5371 - Phone
- (630) 261-1210
- NPI assigned
- Mar 17, 2014
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 209.011113 | IL | Primary |
Addresses
Primary practice location
2340 S Highland Ave
Suite 300
Lombard, IL 60148-5371
Mailing address
2340 S Highland Ave
Suite 300
Lombard, IL 60148-5371
Phone (630) 261-1210
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209.011113 | IL | MD | Psychiatric/Mental Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1395014400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1395100800000",
"number": "1265858013",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2340 S HIGHLAND AVE",
"address_2": "SUITE 300",
"city": "LOMBARD",
"state": "IL",
"postal_code": "601485371",
"telephone_number": "630-261-1210"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2340 S HIGHLAND AVE",
"address_2": "SUITE 300",
"city": "LOMBARD",
"state": "IL",
"postal_code": "601485371",
"telephone_number": "630-261-1210"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLENN",
"first_name": "MARIAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-03-17",
"last_updated": "2014-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "IL",
"license": "209.011113",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lombard, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.