Individual
MRS. LEESA E GILLOOLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
698 FEATHERSTONE RD, ROCKFORD, IL 61107-6303
(815) 398-3277
Mailing address
698 FEATHERSTONE RD, ROCKFORD, IL 61107-6303
(815) 398-3277
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085003368
IL
Other
Enumeration date
12/29/2008
Last updated
06/14/2010
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