Natalie J Gallivan

Primary specialty

Mastectomy FitterTaxonomy code 224900000X

Practice address

3002 Gill St
Bloomington, IL 61704-3438

Phone

(309) 664-7930

Fax

(309) 664-7931

NPI assigned

Apr 17, 2024

Last updated

Apr 17, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Medsource LLC

  • Durable Medical Equipment & Medical Supplies
  • Hales Corners, WI
  • NPI 1275847725
  NPD (past)
• Medsource, LLC

  • Durable Medical Equipment & Medical Supplies
  • Colorado Springs, CO
  • NPI 1801300058
  NPD (past)

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

{
    "created_epoch": "1713312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713312000000",
    "number": "1962257642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28099 W ROCKWELL CT",
            "city": "LAKEMOOR",
            "state": "IL",
            "postal_code": "600516606",
            "telephone_number": "309-664-7930",
            "fax_number": "309-664-7931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3002 GILL ST",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617043438",
            "telephone_number": "309-664-7930",
            "fax_number": "309-664-7931"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Howard Ave Ste 206",
            "address_purpose": "LOCATION",
            "city": "Des Plaines",
            "state": "IL",
            "postal_code": "600185907",
            "country_code": "US",
            "telephone_number": "309-664-7930 x242",
            "fax_number": "309-664-7931",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5300 S 108th St Ste 19",
            "address_purpose": "LOCATION",
            "city": "Hales Corners",
            "state": "WI",
            "postal_code": "531301368",
            "country_code": "US",
            "telephone_number": "309-664-7930 x242",
            "fax_number": "309-664-7931",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GALLIVAN",
        "first_name": "NATALIE",
        "middle_name": "J",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-17",
        "last_updated": "2024-04-17",
        "certification_date": "2024-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224900000X",
            "taxonomy_group": "",
            "desc": "Mastectomy Fitter",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Divya Gade
• Gaggle.Net, Inc. (Gaggle)
• Gailey Eye Clinic, LTD
• Cheryl L. Gaines, L.C.P.C.
• Kelly L Galbraith, APN
• Paiton Galloway
• Gustavo Galue, M.D.
• Allison R Ganther
• Mark Garbek, PA
• Andrea Gardner

• Mastectomy Fitter in Bloomington, IL
• Providers in Bloomington, IL by specialty
• Mastectomy Fitter in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2024; 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.