| Organization Name: | GAILEY EYE CLINIC, LTD |
| NPI Number: | 1184829814 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | REBECCA COX (ADMINISTRATIVE ASSISTANT) |
| Mailing Address: | 322 W Marion Ave Forsyth |
| State: | IL US |
| Postal Code: | 625351064 |
| Phone Number: | 2178727404 |
| Fax Number: | |
| NPI Enumeration Date: | 06/21/2007 |
| NPI Last Update Date: | 05/28/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 156FX1100X |
| License Number: | 042000963 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Eye and Vision Services Providers |
| Taxonomy Classification: | Technician/Technologist |
| Taxonomy Specialization: | Ophthalmic |
| Taxonomy Definition: | |