Galilee Medical Center, S.C.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

GALILEE MEDICAL CENTER, S.C.

Doing business as

Galilee BioMed Lab

Practice address

4200 W 63Rd St
Chicago, IL 60629-5010

Phone

(773) 295-7300

Fax

(773) 295-7335

NPI assigned

May 23, 2022

Last updated

Jul 27, 2022By the provider in NPPES

Organization subpart

Yes

Parent organization

GALILEE MEDICAL CENTER, S.C.As reported in NPPES

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

Authorized official

Name

Tania Khamoo

Title

Manager

Phone

(773) 309-6740

Specialties & licenses 1

Addresses

Other names 1

• Galilee BioMed Lab Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Galilee Medical Center, S.C.

  • Family Medicine Physician
  • Chicago, IL
  • NPI 1497797393

  5395648836

  Same PAC ID

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Galilee Medical Ctr SC3 organizations share this tax ID, including this one

Part of

Galilee Medical Ctr SC

Other organizations with this tax ID 2

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

• Galilee Medical Center S.C.

  • General Practice Physician
  • Chicago, IL
  • NPI 1437104239
  NPD tax ID
• Galilee Medical Center, S.C.

  • Family Medicine Physician
  • Chicago, IL
  • NPI 1497797393
  NPD tax ID

Locations

Practitioners 8

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.

• Ferdinand Catotal, FNP

  • Family Nurse Practitioner
  • Elgin, IL
  • NPI 1538681572
  NPD
• Maurice A Guzman, M.D.

  • Family Medicine Physician
  • Chicago, IL
  • NPI 1528057874
  NPD
• Samer F Najjar, M.D.

  • Vascular Surgery Physician
  • Chicago, IL
  • NPI 1346292547
  NPD
• Naser Rustom, MD

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1154374171
  NPD
• Juanita Valverde, M.D.

  • Family Medicine Physician
  • Chicago, IL
  • NPI 1922258276
  NPD
• Amjad Ali, M.D.

  • Specialist
  • Chicago, IL
  • NPI 1952359184
  NPD (past)
• Michael David Smith, M.D.

  • Diagnostic Radiology Physician
  • Chicago, IL
  • NPI 1386637148
  NPD (past)
• Saidmunib Sana, MD

  • Diagnostic Radiology Physician
  • Fort Collins, CO
  • NPI 1306132725
  NPD (past)

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

{
    "created_epoch": "1653264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658880000000",
    "number": "1497493241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4903 W FULLERTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606392548",
            "telephone_number": "773-237-0755",
            "fax_number": "773-237-0785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 W 63RD ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606295010",
            "telephone_number": "773-295-7300",
            "fax_number": "773-295-7335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GALILEE MEDICAL CENTER, S.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GALILEE MEDICAL CENTER, S.C.",
        "enumeration_date": "2022-05-23",
        "last_updated": "2022-07-27",
        "certification_date": "2022-07-27",
        "status": "A",
        "authorized_official_last_name": "KHAMOO",
        "authorized_official_first_name": "TANIA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "773-309-6740"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Galilee BioMed Lab",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Galilee BioMed Lab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Samantha Galicia, ATC
• Sandra A. Galicia, LCSW
• Melissa Galick
• Galilee Medical Center S.C.
• Galilee Medical Center, S.C. (MRI Lincoln Imaging Center)
• Galilee Medical Center, S.C.
• Galilee Medical Center, S.C. (MRI Lincoln Imaging Center)
• Galilee Medical Center, S.C. (MRI Lincoln Imaging Center)
• Galileo Optical Co. (Eyeland Optical)
• Galileo Optical Co. (Da Vinci Vision Boutique)

• Clinical Medical Laboratory in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Medical Laboratory in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.