IndividualActive
Glen Moeller
NPI 1164130100 · Mental Health Counselor · Gurnee, IL
Provider details
- NPI number
- 1164130100
- Entity type
- Individual
- Primary specialty
- Mental Health CounselorBehavioral Health & Social Service Providers
- Sex
- Male
- Sole proprietor
- No
- License
- 178.020406 (IL)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Behavioral Health & Social Service Providers
Profile Score
Established profile(64/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
3 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1790 Nations Dr Ste 208
Gurnee, IL 60031-9176
Phone: (847) 625-9004
Fax: (847) 625-9073
Street-level locationGet directions
Mailing address
447 Park Ln
Lake Bluff, IL 60044-2322
Additional practice locations (1)
- 715 Lake St Ste 806Oak Park, IL 60301-1417Phone: (773) 312-3612
Registry dates
- Enumerated
- 2022-11-08
- Last updated
- 2024-07-31
- Certified
- 2024-07-31
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.