| Gallup Family Practice,ltd. | |
|
250 W Kensington Rd Suite 1 A Mt Prospect IL 60056-1293 | |
| (847) 483-0200 | |
| (847) 483-0201 |
| Full Name | Gallup Family Practice,ltd. |
|---|---|
| Speciality | Family Medicine |
| Location | 250 W Kensington Rd, Mt Prospect, Illinois |
| Authorized Official Name and Position | Richard E. Gallup (PRESIDENT) |
| Authorized Official Contact | 8474830200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gallup Family Practice,ltd. 250 W Kensington Rd Suite 1 A Mt Prospect IL 60056-1293 Ph: (847) 483-0200 | Gallup Family Practice,ltd. 250 W Kensington Rd Suite 1 A Mt Prospect IL 60056-1293 Ph: (847) 483-0200 |
| NPI Number | 1467784629 |
|---|---|
| Provider Enumeration Date | 02/12/2010 |
| Last Update Date | 02/12/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467784629 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 036090453 (Illinois) | Primary |
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