Healthcare Provider Details

I. General information

NPI: 1720087398
Provider Name (Legal Business Name): KATRINA GALLAGHER N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2005
Last Update Date: 10/12/2022
Certification Date: 10/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12151 REGENCY PKWY STE 12137
HUNTLEY IL
60142-7644
US

IV. Provider business mailing address

600 S RANDALL RD STE 210
ALGONQUIN IL
60102-5937
US

V. Phone/Fax

Practice location:
  • Phone: 847-515-2200
  • Fax: 847-515-2328
Mailing address:
  • Phone: 224-783-4365
  • Fax: 224-783-4356

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number277.000016
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: