Individual
ARIANA GALLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
514 N ELMHURST AVE, MOUNT PROSPECT, IL 60056-2014
(847) 502-7552
Mailing address
514 N ELMHURST AVE, MOUNT PROSPECT, IL 60056-2014
(847) 342-1743
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SKQAN5834765
BLUE CROSS BLUE SHIELD
IL
Enumeration date
06/04/2018
Last updated
06/16/2018
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