Provider Demographics
NPI:1801251376
Name:TG THERAPY LTD.
Entity type:Organization
Organization Name:TG THERAPY LTD.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TARAH
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:GALLOWAY
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC, ATR
Authorized Official - Phone:847-630-4756
Mailing Address - Street 1:721 CAMBRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60193-2664
Mailing Address - Country:US
Mailing Address - Phone:847-630-4756
Mailing Address - Fax:
Practice Address - Street 1:901 BIESTERFIELD RD
Practice Address - Street 2:STE 109
Practice Address - City:ELK GROVE VILLAGE
Practice Address - State:IL
Practice Address - Zip Code:60007-3392
Practice Address - Country:US
Practice Address - Phone:847-979-0025
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-28
Last Update Date:2015-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180009166101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1063821049OtherINDIVIDUAL NPI