Provider Demographics
NPI:1962599324
Name:GALLAI, JAMES BARRY (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:BARRY
Last Name:GALLAI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2441 E 2850TH RD
Mailing Address - Street 2:
Mailing Address - City:MARSEILLES
Mailing Address - State:IL
Mailing Address - Zip Code:61341-9765
Mailing Address - Country:US
Mailing Address - Phone:815-357-8030
Mailing Address - Fax:
Practice Address - Street 1:2441 E 2850TH RD
Practice Address - Street 2:
Practice Address - City:MARSEILLES
Practice Address - State:IL
Practice Address - Zip Code:61341-9765
Practice Address - Country:US
Practice Address - Phone:815-357-8030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2014-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-051227207RP1001X
WI48835-020207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND15154Medicaid
ND15154Medicaid
NDN715009Medicare UPIN