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Individual

MRS. GALAXIE GAVIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
100 W 162ND ST, SOUTH HOLLAND, IL 60473-2003
(708) 730-2200
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1293

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
209017779
IL
363L00000X
Nurse Practitioner
209017779
IL
363LF0000X
Family Nurse Practitioner
Primary
277003010
IL

Other

Enumeration date
06/20/2018
Last updated
10/28/2024
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