Active NPI
Sharon Jo Glassburn, LMFT
- Marriage & Family Therapist
- Chicago, IL
National Provider Identifier
1396264198
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 166.00153
- Practice address
- 30 N Michigan Ave.
Ste 515
Chicago, IL 60602 - Phone
- (312) 623-1845
- Fax
- (312) 623-1845
- NPI assigned
- Sep 12, 2017
- 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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 166.00153 | IL | Primary |
Addresses
Primary practice location
30 N Michigan Ave.
Ste 515
Chicago, IL 60602
Mailing address
4202 N Whipple St.
Apt 1
Chicago, IL 60618
Phone (312) 623-1845
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20251125002302 | IL | Practitioner - Marriage and Family Therapist | 7315439528 | Practice locations: Chicago, IL |
Care Compare profile
Medicare Care Compare- Specialty
- Marriage and Family Therapist
- Education
- Other, 2013
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
23 Market St
New Haven, CT 06513-3028
4631 N Lincoln Ave
Chicago, IL 60625-2007
Phone (203) 212-9757
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 166.00153 | IL | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1505174400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1612828800000",
"number": "1396264198",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4202 N WHIPPLE ST.",
"address_2": "APT 1",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60618",
"telephone_number": "312-623-1845",
"fax_number": "312-256-9166"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30 N MICHIGAN AVE.",
"address_2": "STE 515",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60602",
"telephone_number": "312-623-1845",
"fax_number": "312-623-1845"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLASSBURN",
"first_name": "SHARON",
"middle_name": "JO",
"credential": "LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-09-12",
"last_updated": "2021-02-09",
"certification_date": "2021-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "IL",
"license": "166.00153",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2021; 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.
- 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.