Individual provider Active NPI

Cheryl L Glombicki, CNP

  • Family Nurse Practitioner
  • Woodstock, IL
National Provider Identifier
1881881712
Registry record updated Oct 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209006620 Issued in IL
Practice address
3707 Doty Rd Ste G
Woodstock, IL 60098
Phone
(815) 338-6600
Fax
(815) 338-9488
NPI assigned
Sep 25, 2007
Last updated
Oct 19, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209006620 IL
Family Nurse Practitioner 363LF0000X 209006620 IL Primary
Licensed Practical Nurse 164W00000X 209006620 IL

Addresses

Primary practice location

3707 Doty Rd Ste G
Woodstock, IL 60098

Mailing address

3707 Doty Rd Ste G
Woodstock, IL 60098-7530
Phone (815) 338-6600

Other practice location 1

1925 Huntley Rd
West Dundee, IL 60118-9301
Phone (815) 338-6600

Other practice location 2

10350 Haligus Rd
Huntley, IL 60142-9545
Phone (815) 338-6600

Other practice location 3

360 Station Dr
Crystal Lake, IL 60014-7978
Phone (815) 338-6600

Other practice location 4

2507 N Richmond Rd
McHenry, IL 60051-5407
Phone (815) 338-6600

Other identifiers 1

IdentifierTypeStateIssuer
209006620OtherILSTATE LICENSE

Other names 1

  • Cheryl Smedley Former name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080307000597 IL Practitioner - Nurse Practitioner 9537244058 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Physician Group CurrentSince May 1, 2019 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince May 1, 2019 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince May 1, 2019 Accepting new patients
Central Dupage Physician Group CurrentSince May 1, 2019 Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

680 N Lake Shore Dr
Ste 1000
Chicago, IL 60611
Phone (312) 695-4022

360 Station Dr
Crystal Lake, IL 60014
Phone (815) 477-7350

10350 Haligus Rd
Huntley, IL 60142
Phone (847) 802-7150

11650 S State Route 47
Huntley, IL 60142
Phone (847) 802-7300

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

2507 N Richmond Rd
McHenry, IL 60051
Phone (815) 363-2350

515 Valley View Dr
Ste 201
Moline, IL 61265
Phone (312) 695-0870

1925 Huntley Rd
West Dundee, IL 60118
Phone (847) 854-3421

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

3707 Doty Rd
Woodstock, IL 60098
Phone (815) 206-1068

3707 Doty Rd
Ste G
Woodstock, IL 60098
Phone (815) 334-5018

Interoperability endpoints

  • Direct secure messaging: cheryl.glombicki.1@19247.direct.athenahealth.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1190678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539907200000",
    "number": "1881881712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3707 DOTY RD STE G",
            "city": "WOODSTOCK",
            "state": "IL",
            "postal_code": "600987530",
            "telephone_number": "815-338-6600",
            "fax_number": "815-338-9488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3707 DOTY RD STE G",
            "city": "WOODSTOCK",
            "state": "IL",
            "postal_code": "60098",
            "telephone_number": "815-338-6600",
            "fax_number": "815-338-9488"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1925 Huntley Rd",
            "address_purpose": "LOCATION",
            "city": "West Dundee",
            "state": "IL",
            "postal_code": "601189301",
            "country_code": "US",
            "telephone_number": "815-338-6600",
            "fax_number": "847-426-5162",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10350 Haligus Rd",
            "address_purpose": "LOCATION",
            "city": "Huntley",
            "state": "IL",
            "postal_code": "601429545",
            "country_code": "US",
            "telephone_number": "815-338-6600",
            "fax_number": "847-802-7112",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "360 Station Dr",
            "address_purpose": "LOCATION",
            "city": "Crystal Lake",
            "state": "IL",
            "postal_code": "600147978",
            "country_code": "US",
            "telephone_number": "815-338-6600",
            "fax_number": "815-455-8044",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2507 N Richmond Rd",
            "address_purpose": "LOCATION",
            "city": "McHenry",
            "state": "IL",
            "postal_code": "600515407",
            "country_code": "US",
            "telephone_number": "815-338-6600",
            "fax_number": "815-385-3255",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLOMBICKI",
        "first_name": "CHERYL",
        "middle_name": "L",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-25",
        "last_updated": "2018-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209006620",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209006620",
            "primary": true
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "IL",
            "license": "209006620",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "209006620",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHERYL",
            "last_name": "SMEDLEY",
            "credential": "CNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Woodstock, IL

Sources for this page

Verify at the official NPI Registry.