GLENN R POULESON (NPI# 1679740336) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679740336 |
| Entity Type | Individual |
| Full Name | GLENN R POULESON |
| Credential | DMD |
| Practice Address |
6800 Main St Apex Endodontics #205 Downers Grove IL 60516 |
| Practice Telephone | 6309644499 |
| Practice Fax Number | 6309644523 |
| Mailing Telephone | 6309644499 |
| Mailing Fax Number | 6309644523 |
| Enumeration Date | 2008-05-13 |
| Last Update Date | 2008-05-13 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223E0200X |
Dentist Specialization: Endodontics |
021-001347 | IL | Dental Providers |
| Street Address |
6800 MAIN ST APEX ENDODONTICS #205 |
| City | DOWNERS GROVE |
| State | IL |
| Zip Code | 60516 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316937345 | Nancy A. Congdon, M.s., P.C. | Audiologist | 6800 Main St, #114, Downers Grove, IL 60516-3493 | 2005-10-21 |
| 1053788331 | Jessica Lynne Anderson | Social Worker | 6800 Main St, Suite 210, Downers Grove, IL 60516-3493 | 2015-08-21 |
| 1790117208 | Illinois Neurotherapy Associates | Chiropractor | 6800 Main St, Ste 210, Downers Grove, IL 60516-3493 | 2013-08-07 |
| 1437591880 | Malgorzata Bryja | Dental Hygienist | 6800 Main St, Downers Grove, IL 60516-3493 | 2013-07-26 |
| 1356608665 | Taek Y. Kim, M.d., S.c. | Specialist | 6800 Main St, Suite 215, Downers Grove, IL 60516-3493 | 2012-04-12 |
| 1154622637 | Deluxe Home Health Care LLC | Home Health | 6800 Main St, Suite 020, Downers Grove, IL 60516-3493 | 2010-11-15 |
| 1548584386 | Christine M Ellis | Dental Hygienist | 6800 Main St, Downers Grove, IL 60516-3493 | 2010-03-23 |
| 1952624686 | Tammy F Bernath | Dental Hygienist | 6800 Main St, Downers Grove, IL 60516-3493 | 2010-03-09 |
| 1508018649 | Robin B Blakkolb Dds Ltd | Dentist | 6800 Main St, Suite 106, Downers Grove, IL 60516-3493 | 2008-10-21 |
| 1073702395 | Stephanie Morton | Dental Hygienist | 6800 Main St, Suite 315, Downers Grove, IL 60516-3493 | 2007-10-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174015432 | Costula Cassiani | Behavior Technician | 20w438 Camder Drive, Downers Grove, IL 60516 | 2018-06-02 |
| 1346769130 | Zahra Bohri | Dietitian, Registered | 6337 Blodgett Ct, Downers Grove, IL 60516 | 2017-09-13 |
| 1033567359 | Samuel Brooks Allen | Dentist | 6800 Main St., Third Floor, Downers Grove, IL 60516 | 2016-05-26 |
| 1396019469 | Beverly Woltman | Technician/Technologist | 6800 S. Main Street, Suite Ll5, Downers Grove, IL 60516 | 2012-03-06 |
| 1992080642 | Verna Dianne Velazquez | Counselor | 5630 Hillcrest Rd, Downers Grove, IL 60516 | 2011-10-13 |
| 1598048274 | Rabia Ansari | Optometrist | 1530 W 75th St, Downers Grove, IL 60516 | 2011-09-20 |
| 1487971545 | Brilliant Dental LLC | Dentist | 1400 W 75th St, B1, Downers Grove, IL 60516 | 2010-04-29 |
| 1235466558 | Erika D Schultz | Social Worker | 11008 Palmer St., Downers Grove, IL 60516 | 2009-11-06 |
| 1124253836 | Main Street Chiropractic and Wellness Center Ltd | Clinic/Center | 6234 S Main Street, Downers Grove, IL 60516 | 2009-05-26 |
| 1841439320 | Lisa Marie Burknap | Behavioral Analyst | 9 South 329 Cumnor, Downers Grove, IL 60516 | 2009-02-06 |
| Find all providers in zip 60516 | ||||
| Taxonomy Code | 1223E0200X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Endodontics |
| The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902882798 | Michael John Chutich | Dentist | 3450 Lacey Rd, Downers Grove, IL 60515-5430 | 2005-12-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669089777 | Sebastian Przybylo, Dmd, Pllc | Dentist | 350 S Northwest Hwy Ste 116, Park Ridge, IL 60068-4262 | 2020-09-24 |
| 1770126740 | Old Orchard Endodontics | Dentist | 4905 Old Orchard Ctr Ste 216, Skokie, IL 60077-4741 | 2019-10-23 |
| 1194380741 | Vasiliki Kytridou | Dentist | 2800 College Avenue Southern Il University School of De, Building 285, Alton, IL 62002 | 2019-05-08 |
| 1134782592 | Endodontics of Springfield | Dentist | 997 Clock Tower Dr Ste C, Springfield, IL 62704-1399 | 2019-04-20 |
| 1942793815 | Millennium Dental Specialist | Dentist | 1624 W Division St Ste B, Chicago, IL 60622-3908 | 2018-06-14 |
| 1588163364 | Advanced Endodontics, PC | Dentist | 103 S. Greenleaf Street, Suite K, Gurnee, IL 60031 | 2018-02-07 |
| 1518488055 | Seth Thomas Barnett | Dentist | 3601 General Electric Rd Ste 6, Bloomington, IL 61704-8566 | 2017-07-06 |
| 1023562857 | Jwwdental LLC | Dentist | 808 E Woodfield Rd, Suite 300, Schaumburg, IL 60173-4816 | 2016-08-10 |
| 1629453378 | Charles Richard Neach | Dentist | 801 S Paulina St Rm 302a, Chicago, IL 60612-7210 | 2015-07-23 |
| 1619360096 | Rajan Sharma | Dentist | 6319 Fairview Ave Ste 103, Westmont, IL 60559-2889 | 2015-03-10 |
| Find all providers with the same taxonomy | ||||
| City | DOWNERS GROVE |
| Zip Code | 60516 |
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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.