DR. LISA M GLOSSON (NPI# 1780642678) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780642678 |
| Entity Type | Individual |
| Full Name | DR. LISA M GLOSSON |
| Credential | M.D. |
| Practice Address |
3707 Doty Rd Ste G Woodstock IL 60098 |
| Mailing Address |
3707 Doty Rd Ste G Woodstock IL 60098-7530 |
| Practice Telephone | 8153386600 |
| Practice Fax Number | 8153389488 |
| Mailing Telephone | 8153386600 |
| Mailing Fax Number | 8153389488 |
| Enumeration Date | 2006-05-02 |
| Last Update Date | 2018-10-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 036097016 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | STATE LICENSE | 036097016 | 01 |
| IL | MEDICARE RAILROAD | P00012141 | 01 |
| Street Address |
3707 DOTY RD STE G |
| City | WOODSTOCK |
| State | IL |
| Zip Code | 60098 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346891264 | Joanna Hansen | Nurse Practitioner | 3707 Doty Rd Ste G, Woodstock, IL 60098-7530 | 2019-09-23 |
| 1467866418 | Heli A Desai | Family Medicine | 3707 Doty Rd Ste G, Woodstock, IL 60098 | 2014-06-18 |
| 1881843480 | Megan Peace | Psychologist | 3707 Doty Rd Ste G, Woodstock, IL 60098 | 2008-09-18 |
| 1225202492 | Shelly A Bauer | Licensed Practical Nurse | 3707 Doty Rd Ste G, Woodstock, IL 60098 | 2008-04-17 |
| 1881881712 | Cheryl L Glombicki | Licensed Practical Nurse | 3707 Doty Rd Ste G, Woodstock, IL 60098 | 2007-09-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083197453 | Abb Dental Group LLC | Dentist | 11585 Us 14, Woodstock, IL 60098 | 2018-09-12 |
| 1396256467 | Gezelle Adams | Social Worker | 1200 Walden Oaks Dr, Woodstock, IL 60098 | 2017-10-17 |
| 1861910721 | Letitia Susan Edgell | Technician | 503 Lawndale Ave., Woodstock, IL 60098 | 2017-08-31 |
| 1104355460 | Jessica Evertsen | Doula | 435 Laurel Ave, Woodstock, IL 60098 | 2017-06-08 |
| 1871026724 | Bo Yeon Bartilotta | Dentist | 11585 Us-14, Woodstock, IL 60098 | 2017-04-07 |
| 1619337185 | Julia Karibian | Community Health Worker | 2983 Strauss Court, Woodstock, IL 60098 | 2016-02-26 |
| 1407249170 | Julia Bonti | Counselor | 13318 Hickory Ln, Woodstock, IL 60098 | 2015-03-05 |
| 1427485580 | Sara E Smedinghoff | Physical Therapy Assistant | 708 Washington Street, Woodstock, IL 60098 | 2013-10-03 |
| 1669721783 | Robert Eugene Haraden | Dentist | 651 S. Eastwood Dr, Woodstock, IL 60098 | 2012-09-05 |
| 1831447440 | Carla Peltier | Social Worker | 101 South Jefferson Street, Woodstock, IL 60098 | 2012-08-29 |
| Find all providers in zip 60098 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245844489 | Jovita Zalwango Nassolo | Family Medicine | 116 1/2 N Benton St Apt 2d, Woodstock, IL 60098-3272 | 2020-09-04 |
| 1649623414 | Emily Chan | Family Medicine | 759 S Main St Ste 310, Woodstock, VA 22664-1156 | 2016-07-18 |
| 1164843389 | Stacey A O'brien | Family Medicine | 14205 Highway 92 Ste 105, Woodstock, GA 30188-7138 | 2013-12-16 |
| 1386997765 | Weatherstone Medical Care LLC. | Family Medicine | 3203 S Cherokee Ln, Suite 220, Woodstock, GA 30188-4461 | 2012-10-22 |
| 1629396585 | Lata Parvathaneni | Family Medicine | 900 Towne Lake Pkwy Ste 410, Woodstock, GA 30189-1604 | 2010-05-17 |
| 1992934400 | Donn J. Wiedershine, M.d., P.C. | Family Medicine | 62 Ricks Road, Woodstock, NY 12498 | 2009-07-06 |
| 1699899096 | Hugh P Hermann | Family Medicine | Hugh P. Hermann, 4 The Green, Woodstock, VT 05091 | 2007-03-19 |
| 1538293725 | Hugh P. Hermann, M.d. | Family Medicine | 4 The Grn, Woodstock, VT 05091-1345 | 2007-03-16 |
| 1912038142 | Northside Family Practice, LLC | Family Medicine | 100 Stone Forest Drive, Suite 320, Woodstock, GA 30189 | 2007-03-08 |
| 1336224260 | Jacob Ward | Family Medicine | 1200 Buckhead Xing Ste B, Woodstock, GA 30189-4259 | 2006-10-26 |
| Find all providers in WOODSTOCK | ||||
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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.