Provider Demographics
NPI:1609270859
Name:GALLAGHER, MARGARET (APN)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:GALLAGHER
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:689 OLDE OAK DR
Mailing Address - Street 2:
Mailing Address - City:BOURBONNAIS
Mailing Address - State:IL
Mailing Address - Zip Code:60914-2422
Mailing Address - Country:US
Mailing Address - Phone:815-690-7601
Mailing Address - Fax:
Practice Address - Street 1:125 S WACKER DR
Practice Address - Street 2:SUITE 300
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60606-4424
Practice Address - Country:US
Practice Address - Phone:866-259-1631
Practice Address - Fax:855-618-2629
Is Sole Proprietor?:No
Enumeration Date:2014-10-17
Last Update Date:2015-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209011980363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner