Organization
PROVENA MERCY MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. VIRGENE GALLOWAY OTR/L (OCCUPATIONAL THERAPIST)
(630) 907-0263
Entity
Organization
Contact information
Practice address
136 SPUHLER DR, BATAVIA, IL 60510-1625
(630) 879-1969
Mailing address
136 SPUHLER DR, BATAVIA, IL 60510-1625
(630) 879-1969
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
056.002553
IL
Other
Enumeration date
08/01/2012
Last updated
08/01/2012
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