Individual
SEAN M GALLAGHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2900 FOXFIELD RD STE 100, ST CHARLES, IL 60174-5799
(630) 377-6500
(630) 377-6577
Mailing address
2900 FOXFIELD RD STE 100, ST CHARLES, IL 60174-5799
(630) 377-6500
(630) 377-6577
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085008837
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/21/2020
Last updated
05/03/2023
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