ROBERT S. GLICKENBERGER (NPI# 1407966690) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407966690 |
| Entity Type | Individual |
| Full Name | ROBERT S. GLICKENBERGER |
| Credential | MD |
| Practice Address |
751 N Rutledge St Ste 1100 Springfield IL 62702-4968 |
| Mailing Address |
Po Box 19636 Springfield IL 62794-9636 |
| Practice Telephone | 2175458000 |
| Practice Fax Number | 2175454735 |
| Mailing Telephone | 2175458000 |
| Mailing Fax Number | 2175454735 |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
036-107050 | IL | Allopathic & Osteopathic Physicians |
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
036107050 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | IL LICNESE | 036-107050 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 545 Valley View Dr, Moline, IL 612656138 | 3097625560 | 3097627351 |
| Street Address |
751 N RUTLEDGE ST STE 1100 |
| City | SPRINGFIELD |
| State | IL |
| Zip Code | 62702-4968 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124013636 | Zafar Quader | Internal Medicine | 751 N Rutledge St Ste 1100, Springfield, IL 62702-4968 | 2005-09-12 |
| 1679188437 | Board of Trustees of Southern Illinois University | Clinic/Center | 751 N Rutledge St Ste 1100, Springfield, IL 62702-4968 | 2020-09-09 |
| 1285110213 | Nevin I Corcoran | Nurse Practitioner | 751 N Rutledge St Ste 1100, Springfield, IL 62702-4968 | 2018-07-12 |
| 1922596568 | Hannah J. Bettis | Nurse Practitioner | 751 N Rutledge St Ste 1100, Springfield, IL 62702-4968 | 2018-04-30 |
| 1669983789 | Elizabeth Lauren Stuart | Registered Nurse | 751 N Rutledge St Ste 1100, Springfield, IL 62702-4968 | 2017-10-16 |
| 1831619022 | Cameron Koester | Internal Medicine | 751 N Rutledge St Ste 1100, Springfield, IL 62702-4968 | 2017-06-20 |
| 1346777026 | Nitin Tandan | Internal Medicine | 751 N Rutledge St Ste 1100, Springfield, IL 62702-4968 | 2017-05-12 |
| 1033642509 | Abdul Monem Swied | Internal Medicine | 751 N Rutledge St Ste 1100, Springfield, IL 62702-4968 | 2017-04-11 |
| 1902288988 | Anshul Pandey | Internal Medicine | 751 N Rutledge St Ste 1100, Springfield, IL 62702-4968 | 2015-06-25 |
| 1730561903 | Mohammad Al-akchar | Internal Medicine | 751 N Rutledge St Ste 1100, Springfield, IL 62702 | 2015-06-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457866519 | Mohammad Jamal Uddin Ansari | Internal Medicine | 751 N Rutledge St Ste 400, Springfield, IL 62702 | 2017-12-11 |
| 1588105811 | Mickey Graphia | Surgery | 701 N 1st St # D346, Springfield, IL 62702 | 2017-03-20 |
| 1376908913 | Abdul Hannan | Internal Medicine | 315 W Carpenter St # B, Springfield, IL 62702 | 2015-12-28 |
| 1871986414 | Rachel Hoselton | Nurse Practitioner | 400 N 9th St Fl 4, Springfield, IL 62702 | 2015-03-06 |
| 1548697774 | Alyssa Wilson | Behavioral Analyst | 232 Bruns Lane, One Sparcenter Plaza, Springfield, IL 62702 | 2013-10-02 |
| 1174965446 | Amy Wilson | Speech-Language Pathologist | 2120 West Washington Street, Springfield, IL 62702 | 2013-07-26 |
| 1275898116 | Pele Boutrous Dina | Pediatrics | 415 N 9th St # 4w16, Springfield, IL 62702 | 2012-07-06 |
| 1427327733 | Brook D Croke | Genetic Counselor, MS | 400 N. 9th Street, 3rd Floor Clinic B, Springfield, IL 62702 | 2011-12-16 |
| 1629352604 | Renae M Sanchez | Pharmacist | 3216 East Clearlake Ave, Springfield, IL 62702 | 2011-10-07 |
| 1982915302 | William Leland Zelkovich | Radiology | 701 N 1st, Springfield, IL 62702 | 2010-06-30 |
| Find all providers in zip 62702 | ||||
| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578805610 | Paul Edmond St. Romain | Internal Medicine | 2115 S Fremont Ave Ste 3300, Springfield, MO 65804-2246 | 2013-03-26 |
| 1598026494 | Yesenia Greeff | Internal Medicine | 3300 Main St Ste 3a, Springfield, MA 01199 | 2012-06-06 |
| 1649542713 | Robert Earl Stufflebam | Internal Medicine | 3895 E Pond Apple Dr, Springfield, MO 65809-3752 | 2012-02-03 |
| 1265668263 | Davis L Sim | Internal Medicine | 3355 Riverbend Dr 500, Springfield, OR 97477 | 2009-06-04 |
| 1558549428 | Cheng Zhang | Internal Medicine | 30 W Mccreight Ave Ste 211, Springfield, OH 45504-1853 | 2008-02-04 |
| 1114072444 | John N Green | Internal Medicine | 90 Us Highway 22 W, Springfield, NJ 07081-3110 | 2007-01-25 |
| 1801944632 | Srinivas Channapragada | Internal Medicine | 43 Green Hill Rd, Springfield, NJ 07081-3615 | 2007-01-08 |
| 1598778805 | Challa Ajit | Internal Medicine | 2355 Derr Rd, Springfield, OH 45503-2433 | 2006-08-15 |
| 1215975339 | Gregory Lloyd Lyford | Internal Medicine | 1001 East Primrose St, Springfield, MO 65807 | 2006-06-02 |
| 1467430959 | Harry H Park | Internal Medicine | 1007 Harlow Rd, Ste 210, Springfield, OR 97477-7124 | 2006-01-04 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 62702 |
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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.