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General NPI Number Information
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NPI Number | 1619667656
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Entity Type | Individual
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Provider Name | ASHLEY RAE GALLINA APRN, CNM, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 05/12/2023
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Last Update Date | 02/17/2025
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Provider Practice Location Address
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Address Line | 214 WASHINGTON ST STE 1
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City | INGLESIDE
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State | IL
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Zip | 60041-9208
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Country | US
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Telephone | 815-363-2020
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Fax | 224-225-1003
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Provider Business Mailing Address
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Address Line | 214 WASHINGTON ST STE 1
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City | INGLESIDE
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State | IL
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Zip | 60041-9208
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Country | US
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Telephone | 815-363-2020
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | 209024423
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 209.031083
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License Number State | IL
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