Active NPI
Glenn Martin McClanahan, PH.D.
- Psychologist
- Chicago, IL
National Provider Identifier
1972699726
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- Practice address
- 333 East Ontario Street
Chicago, IL 60611 - Phone
- (312) 401-3623
- NPI assigned
- Oct 5, 2006
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | IL | Primary |
Addresses
Primary practice location
333 East Ontario Street
Chicago, IL 60611
Mailing address
1216 Longvalley Road
Glenview, IL 60025
Phone (312) 401-3623
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 071-004966 | IL | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1972699726",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1216 LONGVALLEY ROAD",
"city": "GLENVIEW",
"state": "IL",
"postal_code": "60025",
"telephone_number": "312-401-3623"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "333 EAST ONTARIO STREET",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60611",
"telephone_number": "312-401-3623"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCLANAHAN",
"first_name": "GLENN",
"middle_name": "MARTIN",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.