Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Glen Anthony Moeller

Individual provider Mental Health Counselor · NPI 1164130100

Glen Anthony Moeller is a Mental Health Counselor in Gurnee, Illinois. Works from 2 locations. Licensed in Illinois.

Licensed in
IL
In the registry since
2022
Specialties on file
2

Practice location Address checks out

1790 Nations Dr Ste 208
Gurnee, IL 60031-9176
Phone: (847) 625-9004
Fax: (847) 625-9073
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 715 Lake St Ste 806, Oak Park, IL 60301-1417 — (773) 312-3612

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence 178.020406 (IL)
Clinical Psychologist Taxonomy 103TC0700X · Licence 101YM0800X (IL)

Record details

NPI number1164130100
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedNovember 8, 2022
Last updated in NPPESJuly 31, 2024
Certification dateJuly 31, 2024
Mailing address447 Park Ln, Lake Bluff, IL 60044-2322

Other providers in Gurnee