Active NPI
William Gallagher, C.O.
- Orthotist
- Chicago, IL
National Provider Identifier
1386975274
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthotist
- License
- IL 21300058
- Practice address
- 345 E Superior St
Chicago, IL 60611-2654 - Phone
- (312) 238-2810
- NPI assigned
- Jan 18, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthotist | 222Z00000X | IL 21300058 | IL | Primary |
Addresses
Primary practice location
345 E Superior St
Chicago, IL 60611-2654
Mailing address
17065 Forest View Dr
Tinley Park, IL 60477-2966
Phone (708) 532-7113
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| IL 21300058 | IL | MD | Orthotist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1263772800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1263859200000",
"number": "1386975274",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17065 FOREST VIEW DR",
"city": "TINLEY PARK",
"state": "IL",
"postal_code": "604772966",
"telephone_number": "708-532-7113"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "345 E SUPERIOR ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606112654",
"telephone_number": "312-238-2810"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GALLAGHER",
"first_name": "WILLIAM",
"name_prefix": "Mr.",
"credential": "C.O.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-01-18",
"last_updated": "2010-01-19",
"status": "A"
},
"taxonomies": [
{
"code": "222Z00000X",
"taxonomy_group": "",
"desc": "Orthotist",
"state": "IL",
"license": "IL 21300058",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.