Most Relevant Information
Provider Data
| NPI Number: | 1003317587 |
| Provider Name: | CORIE LYN GALLAGHER CVRT |
| Entity Type: | Individual |
| Taxonomy Code: | 2255R0406X |
| Specialty: | Specialist/Technologist |
| License Number: |
Most Important Dates
| Enumeration Date: | 02/21/2018 |
| Last Updated: | 02/21/2018 |
Provider Practice Location
5000 S 5TH AVE BLDG 113
HINES
IL
601413030
Practice Location Phone/Fax
| Phone: | 7082027382 |
| Fax: |
Provider Mailing Location
5000 S 5TH AVE BLDG 113
HINES
IL
601413030
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |