Provider Demographics
NPI:1508939471
Name:GALSTON, STEPHEN G (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:G
Last Name:GALSTON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:977 LAKEVIEW PKWY
Mailing Address - Street 2:SUITE170
Mailing Address - City:VERNON HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60061-1400
Mailing Address - Country:US
Mailing Address - Phone:847-367-1611
Mailing Address - Fax:847-367-4079
Practice Address - Street 1:977 LAKEVIEW PKWY
Practice Address - Street 2:SUITE170
Practice Address - City:VERNON HILLS
Practice Address - State:IL
Practice Address - Zip Code:60061-1400
Practice Address - Country:US
Practice Address - Phone:847-367-1611
Practice Address - Fax:847-367-4079
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL731270Medicare ID - Type Unspecified