Active NPI
Glenn Gottner
- Acupuncturist
- McHenry, IL
National Provider Identifier
1770034860
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 198.000834
- Practice address
- 5435 Bull Valley Rd
Suite 118
McHenry, IL 60050-7434 - Phone
- (815) 363-7007
- NPI assigned
- Oct 24, 2016
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Acupuncturist | 171100000X | 198.000834 | IL | Primary |
Addresses
Primary practice location
5435 Bull Valley Rd
Suite 118
McHenry, IL 60050-7434
Mailing address
3581 Lakeview Dr
Algonquin, IL 60102-4815
Phone (847) 458-7660
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 198.000834 | IL | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1477267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1477267200000",
"number": "1770034860",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3581 LAKEVIEW DR",
"city": "ALGONQUIN",
"state": "IL",
"postal_code": "601024815",
"telephone_number": "847-458-7660"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5435 BULL VALLEY RD",
"address_2": "SUITE 118",
"city": "MCHENRY",
"state": "IL",
"postal_code": "600507434",
"telephone_number": "815-363-7007"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOTTNER",
"first_name": "GLENN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-10-24",
"last_updated": "2016-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "IL",
"license": "198.000834",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in McHenry, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.