MRS. GLORIA ANN ENNENBACH (NPI# 1225544901) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225544901 |
| Entity Type | Individual |
| Full Name | MRS. GLORIA ANN ENNENBACH |
| Credential | RN |
| Practice Address |
701 W Lamm Rd Freeport IL 61032-9630 |
| Practice Telephone | 8152336162 |
| Practice Fax Number | 8152336167 |
| Mailing Telephone | 8152336162 |
| Mailing Fax Number | 8152336167 |
| Enumeration Date | 2017-12-18 |
| Last Update Date | 2017-12-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WP0807X |
Registered Nurse Specialization: Psych/Mental Health, Child & Adolescent |
041-332750 | IL | Nursing Service Providers |
| Street Address |
701 W LAMM RD |
| City | FREEPORT |
| State | IL |
| Zip Code | 61032-9630 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285838458 | Judy Ann Strey | Speech-Language Pathologist | 701 W Lamm Rd, Freeport, IL 61032-9630 | 2007-06-12 |
| 1881100600 | Willowglen Academy Illinois | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 701 W Lamm Rd, Freeport, IL 61032-9630 | 2017-12-15 |
| 1215441050 | Willowglen Academy-illinois Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 701 W Lamm Rd, Freeport, IL 61032-9630 | 2017-11-30 |
| 1548703887 | Ervin Wainwright | Social Worker | 701 W Lamm Rd, Freeport, IL 61032-9630 | 2016-11-18 |
| 1932641164 | Erik Walton | Social Worker | 701 W Lamm Rd, Freeport, IL 61032-9630 | 2016-11-04 |
| 1558803783 | Antoinette Harvey | Social Worker | 701 W Lamm Rd, Freeport, IL 61032-9630 | 2016-11-04 |
| 1740732908 | Martrice Collier | Social Worker | 701 W Lamm Rd, Freeport, IL 61032-9630 | 2016-11-03 |
| 1184176448 | Roland Emeka Aguocha | Social Worker | 701 W Lamm Rd, Freeport, IL 61032-9630 | 2016-11-02 |
| 1194277541 | Carrie Snow | Counselor | 701 W Lamm Rd, Freeport, IL 61032-9630 | 2016-11-02 |
| 1710439435 | Willowglen Academy | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 701 W Lamm Rd, Freeport, IL 61032-9630 | 2016-10-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013517713 | Saad Awan | Pharmacist | 2545 Illinois 26 S, Freeport, IL 61032 | 2020-10-30 |
| 1891354460 | Freeport Chiropractic LLC | Chiropractor | 2 W Stephenson St, Freeport, IL 61032 | 2019-06-07 |
| 1487168373 | Lindsey Rae Harris-baker | Speech-Language Pathologist | 1802 W Laurel St, Freeport, IL 61032 | 2017-11-30 |
| 1861871246 | Pearl Pavilion LLC | Skilled Nursing Facility | 910 Kiwanis Drive, Freeport, IL 61032 | 2015-05-19 |
| 1245584598 | Mary E Brown | Massage Therapist | 815 W. Pleasant Street, Freeport, IL 61032 | 2012-11-07 |
| 1700135803 | April Braband | Specialist | 421 Exchange, Freeport, IL 61032 | 2012-09-05 |
| 1518198662 | Quad City Prosthetic Inc | Prosthetic/Orthotic Supplier | 1013 W Loras Dr, Suite A, Freeport, IL 61032 | 2009-08-06 |
| 1447486501 | Gary Alan Besley | Dentist | 1450 S. West Ave., Freeport, IL 61032 | 2009-06-03 |
| 1023244290 | Allies In Health Sc | Chiropractor | 418 W Meadows Dr., Freeport, IL 61032 | 2009-06-02 |
| 1912146614 | Kayla Nicole Rodebaugh | Specialist/Technologist | 1010 Fairway Drive, Freeport, IL 61032 | 2009-02-19 |
| Find all providers in zip 61032 | ||||
| Taxonomy Code | 163WP0807X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Psych/Mental Health, Child & Adolescent |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679932057 | Jennifer Howard | Registered Nurse | 1515 W 9th St, Dixon, IL 61021-3312 | 2016-02-15 |
| 1790143733 | Mitzi Walker | Registered Nurse | 676 Brookwood Dr, Olympia Fields, IL 60461-1510 | 2016-02-05 |
| 1841437787 | Cynthia Louise Petty | Registered Nurse | Uic, Ijr, 1747 West Roosevelt Road, M/c 747, Cu 113, Chicago, IL 60608 | 2009-01-14 |
| 1184839201 | Susan Gail Painter | Registered Nurse | 1056 N Hermitage Ave, #1f, Chicago, IL 60622-3259 | 2007-05-11 |
| 1417926601 | Merle Evelyn Pray | Registered Nurse | 820 S0 Damen Ave, 4292, Chicago, IL 60612 | 2006-03-17 |
| 1376156471 | Cross Counseling and Coaching, Inc. | Registered Nurse | 7 Bronze Pointe S Ste B2, Swansea, IL 62226-8308 | 2020-08-28 |
| 1982230124 | Bradley Thompson | Registered Nurse | 1802 S Mattis Ave, Champaign, IL 61821-5923 | 2020-03-19 |
| 1841706371 | Jesse Dewayne Herron | Registered Nurse | 912 S Wood St # Mc913, Chicago, IL 60612-4300 | 2017-12-20 |
| 1801256813 | Lisa L Henderson | Registered Nurse | 2239 E Cook St, Springfield, IL 62703-1944 | 2016-03-03 |
| 1972979409 | Sarah Schulze | Registered Nurse | 309 W Clark St, Champaign, IL 61820-4637 | 2015-08-19 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.