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:
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Health care specialties

SpecialtyCodeLicense #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 3 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639190200 NPPES
Illinois MEDICAID 036087077

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