Galena Clinic, Inc.

Primary specialty

Methadone ClinicTaxonomy code 261QM2800X

License

A-6258-0001-A Issued in IL

Legal business name

GALENA CLINIC, INC.

Practice address

939 Galena Square Dr
Galena, IL 61036-1355

Phone

(815) 777-1300

Fax

(815) 777-1308

NPI assigned

Apr 7, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Kenneth P Davis, MDNPI 1205040771

Title

President

Phone

(815) 777-1300

Specialties & licenses 2

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kenneth P Davis

  • Psychologist
  • Chicago, IL
  • NPI 1205040771
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1302134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1515024000000",
    "number": "1033408356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "939 GALENA SQUARE DR",
            "city": "GALENA",
            "state": "IL",
            "postal_code": "610361355",
            "telephone_number": "815-777-1300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "939 GALENA SQUARE DR",
            "city": "GALENA",
            "state": "IL",
            "postal_code": "610361355",
            "telephone_number": "815-777-1300",
            "fax_number": "815-777-1308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GALENA CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-07",
        "last_updated": "2018-01-04",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "815-777-1300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "IL",
            "license": "A-6258-0001-A",
            "primary": false
        },
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": "IL",
            "license": "A-6258-0001-A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle C Frangella Finley
• Joyce D Fusek, PSY.D.
• Gail Lynn Gabbert, D.MIN., LMFT
• Galena Area Emergency Medical Service District
• Galena Chiropractic Center PC
• Galena Clinic, Inc.
• Galena Family Dental, P.C.
• Galena River Counseling and Retreats
• Galena Unit SCH Dist 120
• Justin Glen, PT, DPT

• Methadone Clinic in Galena, IL
• Providers in Galena, IL by specialty
• Methadone Clinic in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.