Organization
GALLUP FAMILY PRACTICE,LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD E. GALLUP M.D. (PRESIDENT)
(847) 483-0200
Entity
Organization
Contact information
Practice address
250 W KENSINGTON RD, SUITE 1 A, MT PROSPECT, IL 60056-1293
(847) 483-0200
(847) 483-0201
Mailing address
250 W KENSINGTON RD, SUITE 1 A, MT PROSPECT, IL 60056-1293
(847) 483-0200
(847) 483-0201
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036090453
IL
Other
Enumeration date
02/12/2010
Last updated
02/12/2010
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