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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. GLENN SAMPLE, PSY.D.

Active Sole Proprietor

DR. GLENN SAMPLE, PSY.D. is a Clinical Psychologist healthcare provider located in ROCKFORD, Illinois. NPI 1881915270 is currently active in the NPPES registry. Verify at CMS.

Clinical Psychologist · ROCKFORD, IL

Registration Details

NPI Number
1881915270
Provider Type
Individual
Gender
Male
NPI Issued
Jun 20, 2010 (16.172483222126 yrs)
Last Updated
Mar 8, 2026
Licenses
178010086 (IL)
30340 (CA)
180010078 (IL)
071009666 (IL)
Sole Proprietor
Yes

Practice Information

Address
1643 N ALPINE RD STE 104-609
ROCKFORD, IL, 611071462
Browse IL providers · Browse ZIP 61107
Phone
7732453449
Primary Specialty
Clinical Psychologist
103TC0700X
Additional Specialty
Clinical Psychologist
Additional Specialty
Professional Counselor
Additional Specialty
Clinical Psychologist

Other Clinical Psychologist Providers in ROCKFORD, IL

Name Credential NPI
SHERRY A FALSETTI PHD 1346224375
DR. MARTIN E. WOLFF ED.D. 1437135852
DR. JESSICA DANNENMAIER PSY,D. 1831122100
DR. KYLE J CUSHING PSY.D. 1346259157
JUDITH TRIGG PSY.D 1245243237
JAMES M VIGGIANO PHD 1073609426
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.