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NPI Code Detail

MEDICARE: MR. DONALD M. GLENN LPC

MEDICARE: MR. DONALD M. GLENN LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant085002506IL
2101YP2500XProfessional Counselor178.022326IL

General Provider Information

NPI Number : 1649321944
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. DONALD M. GLENN LPC
Provider Business Mailing Address
First Line : 5440 N PAULINA ST UNIT 1
Second Line :
City : CHICAGO
State : IL
Zip : 60640-1128
Country : US
Telephone Number : 312-576-3163
Fax Number :
Provider Business Practice Location Address
First Line : 5547 N RAVENSWOOD AVE STE 409
Second Line :
City : CHICAGO
State : IL
Zip : 60640-1125
Country : US
Telephone Number : 312-576-3163
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/15/2007
Last Update Date : 11/07/2025

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