Provider Demographics
NPI:1902944622
Name:DUPAGE PODIATRY CENTER, P.C.
Entity Type:Organization
Organization Name:DUPAGE PODIATRY CENTER, P.C.
Other - Org Name:JOLIET PODIATRY CENTER, P.C.
Other - Org Type:Other Name
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:GALLAGHER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:630-971-3338
Mailing Address - Street 1:3550 HOBSON RD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:WOODRIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60517-1434
Mailing Address - Country:US
Mailing Address - Phone:630-971-3338
Mailing Address - Fax:
Practice Address - Street 1:3550 HOBSON RD
Practice Address - Street 2:SUITE 204
Practice Address - City:WOODRIDGE
Practice Address - State:IL
Practice Address - Zip Code:60517-1434
Practice Address - Country:US
Practice Address - Phone:630-971-3338
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DUPAGE PODIATRY CENTER, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-02
Last Update Date:2008-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty