Provider Demographics
NPI:1932377785
Name:GLOTZBACH, PEGGY SUE (LCPC)
Entity Type:Individual
Prefix:MRS
First Name:PEGGY
Middle Name:SUE
Last Name:GLOTZBACH
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:76 W COUNTRYSIDE PKWY
Mailing Address - Street 2:
Mailing Address - City:YORKVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60560-1967
Mailing Address - Country:US
Mailing Address - Phone:630-527-3600
Mailing Address - Fax:
Practice Address - Street 1:76 W COUNTRYSIDE PKWY
Practice Address - Street 2:
Practice Address - City:YORKVILLE
Practice Address - State:IL
Practice Address - Zip Code:60560-1967
Practice Address - Country:US
Practice Address - Phone:630-527-3600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-14
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180-001186101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
1912079062OtherSTENZEL CLINICAL