Individual
MARIA GALANOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
103 N OAK ST, O FALLON, IL 62269-1165
(618) 624-3368
Mailing address
103 N OAK ST, O FALLON, IL 62269-1165
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036-106666
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036106666
BLUE SHIELD
IL
05
—
036106666-4
—
IL
Enumeration date
10/05/2006
Last updated
01/29/2009
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