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General NPI Number Information
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NPI Number | 1497493241
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Entity Type | Organization
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Legal Business Name | GALILEE MEDICAL CENTER, S.C.
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Dates
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Enumeration Date | 05/23/2022
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Last Update Date | 07/27/2022
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Provider Practice Location Address
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Address Line | 4200 W 63RD ST
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City | CHICAGO
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State | IL
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Zip | 60629-5010
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Country | US
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Telephone | 773-295-7300
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Fax | 773-295-7335
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Provider Business Mailing Address
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Address Line | 4903 W FULLERTON AVE
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City | CHICAGO
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State | IL
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Zip | 60639-2548
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Country | US
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Telephone | 773-237-0755
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Fax | 773-237-0785
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Authorized Official
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Title or Position | MANAGER
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Name | TANIA KHAMOO
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Credential |
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Telephone | 773-309-6740
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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