Individual
GLENDON BURRESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2300 N. ROCKTON AVE., ROCKFORD HEALTH PHYSICIANS, ROCKFORD, IL 61103
(815) 971-2000
Mailing address
2300 N. ROCKTON AVE., ROCKFORD HEALTH PHYSICIANS, ROCKFORD, IL 61103
(815) 971-2000
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
036087077
IL
2080P0206X
Pediatric Gastroenterology Physician
Primary
036087077
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036087077
—
IL
Enumeration date
07/21/2006
Last updated
06/20/2022
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