Individual
CAROLYN JEAN GALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
101 N MAIN ST, WALNUT, IL 61376
(815) 379-2020
(815) 379-2018
Mailing address
101 E MILLER RD, STERLING, IL 61081-1252
(815) 625-4790
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085001195
IL
363A00000X
Physician Assistant
2224
CO
363AM0700X
Medical Physician Assistant
5541
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
085001195
—
IL
Enumeration date
10/05/2007
Last updated
10/15/2020
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