NPIMap

Organization Active NPI

Galesburg Clinic PC

  • Specialist
  • Galesburg, IL
National Provider Identifier
1972614808
Registry record updated Feb 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
GALESBURG CLINIC PC
Practice address
3315 N Seminary St
Galesburg, IL 61401-1251
Phone
(309) 344-9371
Fax
(309) 344-1054
NPI assigned
Aug 31, 2006
Last updated
Feb 12, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2008

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

Authorized official

Name
Mary H Michalek
Title
Ceo
Phone
(309) 344-9371

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X NU Primary

Addresses

Primary practice location

3315 N Seminary St
Galesburg, IL 61401-1251

Mailing address

3315 N Seminary St
Galesburg, IL 61401-1251
Phone (309) 344-9371

Other identifiers 1

IdentifierTypeStateIssuer
4815127OtherILB/C B/S

National Provider Directory

National Provider Directory

Locations

120 E Gale St
Williamsfield, IL 61489
Phone (309) 344-1000

Practitioners & affiliated clinicians

Practitioners 31

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202774400000",
    "number": "1972614808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3315 N SEMINARY ST",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614011251",
            "telephone_number": "309-344-9371",
            "fax_number": "309-344-1054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3315 N SEMINARY ST",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614011251",
            "telephone_number": "309-344-9371",
            "fax_number": "309-344-1054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GALESBURG CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2008-02-12",
        "status": "A",
        "authorized_official_last_name": "MICHALEK",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "309-344-9371"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "B/C B/S",
            "identifier": "4815127",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Galesburg, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2008; 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.