Provider Demographics
NPI:1588964357
Name:GAL, KRYSTYNA (DO)
Entity type:Individual
Prefix:
First Name:KRYSTYNA
Middle Name:
Last Name:GAL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16001 108TH AVE
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60467-8788
Mailing Address - Country:US
Mailing Address - Phone:708-460-0007
Mailing Address - Fax:
Practice Address - Street 1:16001 108TH AVE
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60467-8788
Practice Address - Country:US
Practice Address - Phone:708-460-0007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-27
Last Update Date:2017-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOT012634208D00000X
IL036.132226207YS0123X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic Surgery
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice