Individual provider Active NPI

Judith Horwitz Glassenberg, MD

  • Pediatrics Physician
  • Evanston, IL
National Provider Identifier
1750691002
Registry record updated Dec 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
036133246 Issued in IL
Practice address
1285 Hartrey Ave
Erie Family Health Center
Evanston, IL 60202-1056
Phone
(847) 666-2313
Fax
(847) 868-8964
NPI assigned
Oct 19, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 036133246 IL Primary

Addresses

Primary practice location

1285 Hartrey Ave
Erie Family Health Center
Evanston, IL 60202-1056

Mailing address

1285 Hartrey Ave
Erie Family Health Center
Evanston, IL 60202-1056
Phone (847) 666-2313

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131122000232 IL Practitioner - Pediatric Medicine 1951537976 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036133246ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Erie Family Health Center Inc. CurrentSince Sep 22, 2015 Accepting new patients

Locations

1701 W Superior St
Fl 2
Chicago, IL 60622
Phone (323) 361-2122

1701 W Superior St
Fl 3
Chicago, IL 60622
Phone (312) 432-7381

251 E Huron St
Chicago, IL 60611

1504 S Albany Ave
Chicago, IL 60623

1701 W Superior St
Chicago, IL 60622
Phone (312) 432-7392

Interoperability endpoints

  • Direct secure messaging: jhorwitzglassenberg368557@direct.ochin.org

Organizations & group practices 2

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": "1287446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386028800000",
    "number": "1750691002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1285 HARTREY AVE",
            "address_2": "ERIE FAMILY HEALTH CENTER",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602021056",
            "telephone_number": "847-666-2313",
            "fax_number": "847-868-8964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1285 HARTREY AVE",
            "address_2": "ERIE FAMILY HEALTH CENTER",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602021056",
            "telephone_number": "847-666-2313",
            "fax_number": "847-868-8964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HORWITZ GLASSENBERG",
        "first_name": "JUDITH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-19",
        "last_updated": "2013-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036133246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

Verify at the official NPI Registry.