Burress, Glendon
Burress, Glendon is an individual health care provider with primary practice located at 2300 N. Rockton Ave. Rockford Health Physicians, Rockford IL 61103. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Gastroenterology. Allopathic & Osteopathic Physicians / Pediatric Gastroenterology is his primary health care specialty. Burress, Glendon can be contacted via phone (815) 971-2000.Contact Information
Primary practice address
2300 N. Rockton Ave. Rockford Health Physicians
Rockford IL 61103
Phone: (815) 971-2000
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 036087077 | Illinois |
| Allopathic & Osteopathic Physicians / Pediatric Gastroenterology | 2080P0206X | 036087077 | Illinois |
Profile Details
| NPI number | 1639190200 |
|---|---|
| LBN Legal business name | Burress, Glendon |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 21st, 2006 |
| Last updated | Jun 20th, 2022 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1639190200 | NPPES |
| Illinois | MEDICAID | 036087077 |
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