| Organization Name: | GAILEY EYE CLINIC, LTD |
| NPI Number: | 1033353644 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | REBECCA COX (ADMINISTRATIVE ASSISTANT) |
| Mailing Address: | 2435 Village Green Pl Champaign |
| State: | IL US |
| Postal Code: | 618227676 |
| Phone Number: | 2173981700 |
| Fax Number: | 2173983700 |
| NPI Enumeration Date: | 04/27/2009 |
| NPI Last Update Date: | 12/31/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 156FX1100X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Eye and Vision Services Providers |
| Taxonomy Classification: | Technician/Technologist |
| Taxonomy Specialization: | Ophthalmic |
| Taxonomy Definition: | |