Glenn Alden Harrison, M.D.

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

License

036091413 Issued in IL

Practice address

3319 N Elston Ave
Suite 100
Chicago, IL 60618-5811

Phone

(773) 751-7200

Fax

(773) 583-4295

NPI assigned

Mar 2, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Forever Care Home Visiting Physicians Inc

  • Multi-Specialty Clinic/Center
  • Des Plaines, IL
  • NPI 1851865364
  NPD
• Lake Mi Mobile Doctors, P.C.

  dba Mobile Doctors of Chicago

  • Geriatric Medicine (Internal Medicine) Physician
  • Chicago, IL
  • NPI 1437106465
  NPD (past)
• Lake Mi Mobile Doctors, P.C.

  dba Mobile Doctors of Chicago Podiatry

  • Primary Podiatric Medicine Podiatrist
  • Chicago, IL
  • NPI 1992870281
  NPD (past)
• Mobile Ultrasound LLC

  dba Mobile Ultrasound of Kansas City

  • Vascular Specialist/Technologist Cardiovascular
  • Kansas City, MO
  • NPI 1407113517
  NPD (past)

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485993600000",
    "number": "1316076946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7301 N LINCOLN AVE",
            "address_2": "STE 183",
            "city": "LINCOLNWOOD",
            "state": "IL",
            "postal_code": "607121736",
            "telephone_number": "224-766-7669",
            "fax_number": "847-674-0892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3319 N ELSTON AVE",
            "address_2": "SUITE 100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606185811",
            "telephone_number": "773-751-7200",
            "fax_number": "773-583-4295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRISON",
        "first_name": "GLENN",
        "middle_name": "ALDEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-02",
        "last_updated": "2017-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036091413",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "IL",
            "license": "036091413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Harrison Square
• Bradley Edward Harrison, DDS, MPH
• Cameron Blake Harrison
• Casandra Harrison, RN
• Colleen A. Harrison, PA-C
• Imari B Harrison
• Isaiah Harrison
• Jacqueline Lee Harrison, M.D.
• Jennifer Lynne Harrison, MHS
• Julia Harrison

• Geriatric Medicine (Internal Medicine) Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Geriatric Medicine (Internal Medicine) Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2017; 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.

Verify at the official NPI Registry.