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Individual

MR. RYAN T GALLAGHER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
APN-CNP

Contact information

Practice address
303 W LAKE ST STE 301, ADDISON, IL 60101-2565
(331) 221-1650
(331) 221-2710
Mailing address
303 W LAKE ST STE 301, ADDISON, IL 60101-2565
(331) 221-1650
(331) 221-2710

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209029542
IL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
209.029542
IL

Other

Enumeration date
06/14/2024
Last updated
06/26/2024
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