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NATALIE J GALLIVAN
NPI 1962257642
Mastectomy Fitter in Bloomington, IL

Active since April 17, 2024
3002 GILL ST, BLOOMINGTON, IL 61704(309) 664-7930(309) 664-7931 Get Directions Write a Review

NPPES record last updated: April 17, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Natalie J Gallivan NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NATALIE J GALLIVAN (NPI 1962257642) is an individual mastectomy fitter provider in Bloomington, Illinois and active in the NPI registry since April 2024. She maintains 2 additional practice locations.

NPPES Registry Identity

NPI1962257642
Entity TypeIndividualFemale
Primary Taxonomy224900000X
Provider Legal NameNATALIE J GALLIVAN
Location Address3002 GILL STBloomington, IL 61704-3438
Mailing Address28099 W Rockwell CtLakemoor, IL 60051-6606 · (309) 664-7930 · Fax (309) 664-7931
Phone(309) 664-7930
Fax(309) 664-7931
Sole ProprietorNo
Enumeration DateApril 17, 2024
NPPES CertifiedApril 17, 2024
✔ NPI 1962257642 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMastectomy FitterRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code224900000X
Definition
An individual trained in the fitting and adjusting of breast prostheses and management of post-mastectomy prostheses services.
3002 GILL ST, Bloomington, IL 61704
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Secondary Practice Locations 2

Location 1200 Howard Ave Ste 206Des Plaines, IL 60018-5907 · Phone (309) 664-7930 ext. 242 · Fax (309) 664-7931
Location 25300 S 108th St Ste 19Hales Corners, WI 53130-1368 · Phone (309) 664-7930 ext. 242 · Fax (309) 664-7931

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. MELISSA LOUISE PAROCHETTI CST
Specialist/Technologist, Other (Surgical Assistant)
3002 GILL ST, SUITE#3
BLOOMINGTON, IL 61704
McLean County (309) 846-4716
KHIN AYE HTWE CFA
Specialist/Technologist, Other (Surgical Assistant)
3002 GILL ST
BLOOMINGTON, IL 61704
McLean County (847) 204-6943
ELITE MEDICAL GROUP
Durable Medical Equipment & Medical Supplies
3002 GILL ST
BLOOMINGTON, IL 61704
McLean County (309) 663-4443
MS. PAULA DELORES MALONE CST/RST, SA
Specialist/Technologist, Other (Surgical Assistant)
3002 GILL ST, SUITE #3
BLOOMINGTON, IL 61704
McLean County (309) 846-4716
MRS. PEGGY JEAN ZIEL R.N.
Specialist/Technologist, Other (Surgical Assistant)
3002 GILL ST, SUITE #3
BLOOMINGTON, IL 61704
McLean County (309) 846-4716
MISS AMBER DESHEA LEE CST/CFA
Specialist/Technologist, Other (Surgical Assistant)
3002 GILL ST, SUITE #3
BLOOMINGTON, IL 61704
McLean County (309) 846-4716
MRS. THERESE MARIE LESMEISTER RN
Specialist/Technologist, Other (Surgical Assistant)
3002 GILL ST, SUITE#3
BLOOMINGTON, IL 61704
McLean County (309) 846-4716
MS. DEANNE MARIE BURNETT SURGICAL ASSISTANT
Specialist/Technologist, Other (Surgical Assistant)
3002 GILL ST, SUITE 3
BLOOMINGTON, IL 61704
McLean County (309) 846-4716

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Natalie Gallivan's NPI number?

The NPI number for Natalie Gallivan is 1962257642. It was assigned to this individual provider in the NPPES registry on April 17, 2024.

Where is Natalie Gallivan located?

Natalie Gallivan practices at 3002 Gill St, Bloomington, IL 61704. The listed phone number is (309) 664-7930.

What is Natalie Gallivan's specialty?

The primary specialty registered for this NPI is Mastectomy Fitter with taxonomy code 224900000X.

When was this NPI record last updated?

The NPPES record for Natalie Gallivan was last updated on April 17, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.