Individual
MICHAEL GALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.N.
Contact information
Practice address
145 S VIRGINIA ST, SUITE C, CRYSTAL LAKE, IL 60014-7226
(815) 444-9999
(815) 356-6680
Mailing address
930 W WINONA ST, APT 503, CHICAGO, IL 60640-3219
(712) 204-1217
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
041405871
IL
Other
Enumeration date
12/30/2016
Last updated
12/30/2016
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