Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | 125.065951 | IL |
NPI | 1386052629 |
---|---|
Provider Name | Dr. Thomas Kevin Gallagher |
First Address | Chicago, IL 60611 |
Second Address | Chicago, IL 60611 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2014 |
Last Update Date | 23/09/2014 |