IndividualActive
Natalie Gallivan
NPI 1962257642 · Mastectomy Fitter · Bloomington, IL
Provider details
- NPI number
- 1962257642
- Entity type
- Individual
- Primary specialty
- Mastectomy FitterRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Sex
- Female
- Sole proprietor
- No
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
3002 Gill St
Bloomington, IL 61704-3438
Phone: (309) 664-7930
Fax: (309) 664-7931
Approximate (ZIP-level) locationGet directions
Mailing address
28099 W Rockwell Ct
Lakemoor, IL 60051-6606
Additional practice locations (2)
- 200 Howard Ave Ste 206Des Plaines, IL 60018-5907Phone: (309) 664-7930Fax: (309) 664-7931
- 5300 S 108th St Ste 19Hales Corners, WI 53130-1368Phone: (309) 664-7930Fax: (309) 664-7931
Registry dates
- Enumerated
- 2024-04-17
- Last updated
- 2024-04-17
- Certified
- 2024-04-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.