Search › Illinois › 103TC0700X
Glenn Sample, PSY.D
NPI 1881915270 · on the registry since 2010 · sole proprietor
Practice
- Address
- 1643 N Alpine Rd Ste 104-609
Rockford, IL 61107 - Phone
- (773) 245-3449
- Organisation at this address
- Edgebrook Physical Therapy, Inc.
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 5
Registry record
- Primary taxonomy
- 103TC0700X
103TC0700X
- Also registered as
- 101YP2500X
103TC0700X
101YP2500X - Licence states on file
- IL, CA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2026-03-08
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois