NPIMap

Organization Active NPI

Galilee Medical Center S.C.

  • General Practice Physician
  • Chicago, IL
National Provider Identifier
1437104239
Registry record updated Mar 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
042-616-998 Issued in IL
Legal business name
GALILEE MEDICAL CENTER S.C.
Practice address
4941 N. Kedzie Ave
Chicago, IL 60625
Phone
(773) 509-9099
Fax
(773) 509-9006
NPI assigned
May 23, 2006
Last updated
Mar 4, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Naser Rustom, M.D.NPI 1154374171
Title
Owner
Phone
(773) 561-9100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208D00000X 042-616-998 IL Primary

Addresses

Primary practice location

4941 N. Kedzie Ave
Chicago, IL 60625

Mailing address

4941 N. Kedzie Ave
Chicago, IL 60625
Phone (773) 509-9099

National Provider Directory

National Provider Directory
Tax ID family
Galilee Medical Center3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236124800000",
    "number": "1437104239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4941 N. KEDZIE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60625",
            "telephone_number": "773-509-9099",
            "fax_number": "773-509-9006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4941 N. KEDZIE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60625",
            "telephone_number": "773-509-9099",
            "fax_number": "773-509-9006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GALILEE MEDICAL CENTER S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-23",
        "last_updated": "2009-03-04",
        "status": "A",
        "authorized_official_last_name": "RUSTOM",
        "authorized_official_first_name": "NASER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-561-9100",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "IL",
            "license": "042-616-998",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.