Individual provider Active NPI

Wayne R Glad, PHD

  • Psychologist
  • Lake Forest, IL
National Provider Identifier
1689656803
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
071002465 Issued in IL
Practice address
900 N Westmoreland Rd
Ste LL70
Lake Forest, IL 60045-1674
Phone
(847) 295-0340
Fax
(847) 295-0351
NPI assigned
Nov 15, 2005
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 071002465 IL Primary

Addresses

Primary practice location

900 N Westmoreland Rd
Ste LL70
Lake Forest, IL 60045-1674

Mailing address

900WW North Shore Dr 160
Lake Bluff, IL 60044-2218
Phone (847) 295-0340

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

NPI Registry JSON

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

{
    "created_epoch": "1132012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1689656803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900WW NORTH SHORE DR 160",
            "city": "LAKE BLUFF",
            "state": "IL",
            "postal_code": "600442218",
            "telephone_number": "847-295-0340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 N WESTMORELAND RD",
            "address_2": "STE LL70",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600451674",
            "telephone_number": "847-295-0340",
            "fax_number": "847-295-0351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLAD",
        "first_name": "WAYNE",
        "middle_name": "R",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-15",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IL",
            "license": "071002465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Forest, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.