Individual provider Active NPI

Mark John Glesener, D.C.

  • Chiropractor
  • St Charles, IL
National Provider Identifier
1306848387
Registry record updated Sep 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038-006085 Issued in IL
Practice address
1750 E Main St Ste 60
St Charles, IL 60174-2363
Phone
(630) 377-8844
Fax
(630) 377-8404
NPI assigned
Aug 10, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038-006085 IL Primary

Addresses

Primary practice location

1750 E Main St Ste 60
St Charles, IL 60174-2363

Mailing address

1750 E Main St Ste 60
St Charles, IL 60174-2363
Phone (630) 377-8844

Other identifiers 1

IdentifierTypeStateIssuer
04532055OtherILBLUE CROSS BLUE SHIELD #

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL drg@drglesener.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050108000022 IL Practitioner - Chiropractic 5193773935 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1750 E Main St
Suite 60
St Charles, IL 60174-2363
Phone (630) 377-8844

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038-006085ILMDChiropractor

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788220800000",
    "number": "1306848387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1750 E MAIN ST STE 60",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601742363",
            "telephone_number": "630-377-8844",
            "fax_number": "630-377-8404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 E MAIN ST STE 60",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601742363",
            "telephone_number": "630-377-8844",
            "fax_number": "630-377-8404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLESENER",
        "first_name": "MARK",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-10",
        "last_updated": "2026-09-01",
        "certification_date": "2026-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038-006085",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD #",
            "identifier": "04532055",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "drg@drglesener.com",
            "affiliation": "N",
            "endpointDescription": "drg@drglesener.com",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1750 E Main St",
            "address_2": "Suite #60",
            "city": "St Charles",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601742363",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in St Charles, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.