Active NPI
Mark Glazer, M.D.
- Ophthalmology Physician
- Highland Park, IL
National Provider Identifier
1962680363
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 036-066674
- Practice address
- 1110 Sheridan Rd
Highland Park, IL 60035-4119 - Phone
- (847) 217-8122
- Fax
- (847) 433-6341
- NPI assigned
- Feb 7, 2008
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 036-066674 | IL | Primary |
Addresses
Primary practice location
1110 Sheridan Rd
Highland Park, IL 60035-4119
Mailing address
1110 Sheridan Rd
Highland Park, IL 60035-4119
Phone (847) 217-8122
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 Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-066674 | IL | MD | Ophthalmology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Senior Eye Associates SC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Optometrist
- Chicago, IL
- NPI 1316088305
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1202342400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1210291200000",
"number": "1962680363",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1110 SHERIDAN RD",
"city": "HIGHLAND PARK",
"state": "IL",
"postal_code": "600354119",
"telephone_number": "847-217-8122",
"fax_number": "847-433-6341"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1110 SHERIDAN RD",
"city": "HIGHLAND PARK",
"state": "IL",
"postal_code": "600354119",
"telephone_number": "847-217-8122",
"fax_number": "847-433-6341"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLAZER",
"first_name": "MARK",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-02-07",
"last_updated": "2008-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "IL",
"license": "036-066674",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Highland Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.