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NPI Code Detail

MEDICARE: GALILEE MEDICAL CENTER, S.C.

MEDICARE: GALILEE MEDICAL CENTER, S.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1291U00000XClinical Medical Laboratory

General Provider Information

NPI Number : 1497493241
Entity Type Code : Organization
Provider Name (Legal Business Name) : GALILEE MEDICAL CENTER, S.C.
Provider Business Mailing Address
First Line : 4903 W FULLERTON AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60639-2548
Country : US
Telephone Number : 773-237-0755
Fax Number : 773-237-0785
Provider Business Practice Location Address
First Line : 4200 W 63RD ST
Second Line :
City : CHICAGO
State : IL
Zip : 60629-5010
Country : US
Telephone Number : 773-295-7300
Fax Number : 773-295-7335
Authorized Official
Title or Position : MANAGER
Name : TANIA KHAMOO
Credential :
Telephone Number : 773-309-6740
Provider Enumeration Date : 05/23/2022
Last Update Date : 07/27/2022

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Directions to “GALILEE MEDICAL CENTER, S.C. ” Practice Location

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