Healthcare Provider Details

I. General information

NPI: 1083981831
Provider Name (Legal Business Name): CHRISTINE A GALLUP MS RD LDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/22/2011
Last Update Date: 08/29/2025
Certification Date: 08/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8741 S GREENWOOD AVE STE 106-108
CHICAGO IL
60619-7061
US

IV. Provider business mailing address

6119 HALLORAN LN
HOFFMAN ESTATES IL
60192-4817
US

V. Phone/Fax

Practice location:
  • Phone: 773-920-2755
  • Fax:
Mailing address:
  • Phone: 847-742-9280
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number5249
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number2516
License Number StateAR
# 3
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number121918
License Number StateIA
# 4
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number5379
License Number StateMN
# 5
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number164003216
License Number StateIL
# 6
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number2957
License Number StateKS
# 7
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number37003594A
License Number StateIN
# 8
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number2022030614
License Number StateMO
# 9
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberLD.09822
License Number StateOH
# 10
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number831770
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: