Provider Demographics
NPI:1124438007
Name:GALLAGHER, CHERYL MARLA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:MARLA
Last Name:GALLAGHER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:159 N MARION ST
Mailing Address - Street 2:# 240
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60301-1032
Mailing Address - Country:US
Mailing Address - Phone:708-380-2195
Mailing Address - Fax:708-386-7016
Practice Address - Street 1:159 N MARION ST
Practice Address - Street 2:# 240
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60301-1032
Practice Address - Country:US
Practice Address - Phone:708-380-2195
Practice Address - Fax:708-386-7016
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-01
Last Update Date:2014-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051-037785183500000X
CARPH 40616183500000X
NV09284183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist