Provider Demographics
NPI:1366431504
Name:GALEN, DEBORAH JEANNE (MD)
Entity type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:JEANNE
Last Name:GALEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:DEBORAH
Other - Middle Name:J
Other - Last Name:GALEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:321 INDIAN HILL DR
Mailing Address - Street 2:
Mailing Address - City:BUFFALO GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60089-1902
Mailing Address - Country:US
Mailing Address - Phone:847-688-5556
Mailing Address - Fax:847-688-2512
Practice Address - Street 1:2410 SAMPSON ST
Practice Address - Street 2:FISHER CLINIC, BLDG 237
Practice Address - City:GREAT LAKES
Practice Address - State:IL
Practice Address - Zip Code:60088-2942
Practice Address - Country:US
Practice Address - Phone:847-688-5556
Practice Address - Fax:847-688-2512
Is Sole Proprietor?:No
Enumeration Date:2005-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice