Individual
DR. MATTHEW PAUL GULLONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
ONE MEDICAL CENTER DR, GALENA, IL 61036
(815) 777-1340
(815) 776-7274
Mailing address
ONE MEDICAL CENTER DR, GALENA, IL 61036
(815) 777-1340
(815) 776-7274
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036123588
IL
207Q00000X
Family Medicine Physician
11013121A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036123588
LICENSE
IL
01
—
11013121A
LICENSE
IN
Enumeration date
07/03/2006
Last updated
10/14/2020
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