Provider Demographics
NPI:1316211451
Name:YORK, GLENN
Entity type:Individual
Prefix:
First Name:GLENN
Middle Name:
Last Name:YORK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 SHUMAN BLVD
Mailing Address - Street 2:STE 401
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-8458
Mailing Address - Country:US
Mailing Address - Phone:630-303-5380
Mailing Address - Fax:978-313-6824
Practice Address - Street 1:2700 N O'CONNOR
Practice Address - Street 2:STE 102B
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75062-5698
Practice Address - Country:US
Practice Address - Phone:972-252-9360
Practice Address - Fax:972-252-7516
Is Sole Proprietor?:No
Enumeration Date:2012-03-07
Last Update Date:2016-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80288237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist