Myron Glassenberg, MD

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

036045748 Issued in IL

Practice address

2740 W Foster Ave
Ste 108
Chicago, IL 60625-3500

Phone

(773) 989-5571

Fax

(773) 989-4471

NPI assigned

Sep 7, 2006

Last updated

Jan 12, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Swedish Covenant Management Services, Inc.

  dba Swedish Covenant Medical Group

  • Obstetrics & Gynecology Physician
  • Chicago, IL
  • NPI 1760432348

  Neurology

  Medicare reassignment NPD
• Swedish Covenant Management Services, Inc

  dba Swedish Emergency Medicine

  • Emergency Medicine Physician
  • Chicago, IL
  • NPI 1962049551
  NPD
• Multispecialty Medical Center LTD

  • Medical Specialty Clinic/Center
  • Hinsdale, IL
  • NPI 1679507628
  NPD (past)

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452556800000",
    "number": "1487758850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2740 W FOSTER AVE",
            "address_2": "LL7",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60625",
            "telephone_number": "773-878-8200",
            "fax_number": "773-293-4197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2740 W FOSTER AVE",
            "address_2": "STE 108",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606253500",
            "telephone_number": "773-989-5571",
            "fax_number": "773-989-4471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLASSENBERG",
        "first_name": "MYRON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-07",
        "last_updated": "2016-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IL",
            "license": "036045748",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036045748",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "406120086",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tiambriss Glass Kuntu, LCSW
• Anna Glass, MA, LCPC
• Dianne Glass
• Nicole Glass, MA
• Sharon Jo Glassburn, LMFT
• Raymond Glassenberg, MD
• Susan Glassenberg
• Nathaniel Joseph Glasser, M.D.
• Glasses on Oak St (Glasses, Ltd.)
• Anne Elizabeth Glassgow, PHD

• Neurology Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Neurology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2016; 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.