Individual provider Active NPI

Paula Galmore

  • Driver
  • Sauk Village, IL
National Provider Identifier
1467919936
Registry record updated Feb 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DriverTaxonomy code 172A00000X
License
G45667777887 Issued in IL
Practice address
21646 Clyde Ave
Sauk Village, IL 60411-4446
Phone
(708) 600-2147
NPI assigned
Feb 21, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 21, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DriverGroup: 193200000X MULTI-SPECIALTY GROUP 172A00000X G45667777887 IL Primary

Addresses

Primary practice location

21646 Clyde Ave
Sauk Village, IL 60411-4446

Mailing address

21646 Clyde Ave
Sauk Village, IL 60411-4446
Phone (708) 600-2147

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

LicenseStateTypeSpecialty
G45667777887ILMDDriver

NPI Registry JSON

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

{
    "created_epoch": "1550707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550707200000",
    "number": "1467919936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21646 CLYDE AVE",
            "city": "SAUK VILLAGE",
            "state": "IL",
            "postal_code": "604114446",
            "telephone_number": "708-600-2147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21646 CLYDE AVE",
            "city": "SAUK VILLAGE",
            "state": "IL",
            "postal_code": "604114446",
            "telephone_number": "708-600-2147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALMORE",
        "first_name": "PAULA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-21",
        "last_updated": "2019-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Driver",
            "state": "IL",
            "license": "G45667777887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sauk Village, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2019; 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.