Theodore J Galvani Jr., MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

036-089612 Issued in IL

Practice address

3021 Falling Waters Blvd
Suite a
Lindenhurst, IL 60046-6793

Phone

(847) 356-9300

Fax

(847) 356-7260

NPI assigned

Aug 20, 2006

Last updated

Mar 12, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Back in Action Holistic Health Center

  • Chiropractor
  • Rockford, IL
  • NPI 1063554343
  NPD (past)
• Northern Illinois Medical Group S. C.

  • Family Medicine Physician
  • Rockford, IL
  • NPI 1861670101
  NPD (past)
• Unified Therapeutics LLC

  • Family Medicine Physician
  • Chicago, IL
  • NPI 1154590305
  NPD (past)
• Aurora Medical Group, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Union Grove, WI
  • NPI 1245440601
  NPD (past)
• Aurora Medical Group, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Oshkosh, WI
  • NPI 1326858044
  NPD (past)

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268352000000",
    "number": "1801901814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3021 FALLING WATERS BLVD",
            "address_2": "SUITE A",
            "city": "LINDENHURST",
            "state": "IL",
            "postal_code": "600466793",
            "telephone_number": "847-356-9300",
            "fax_number": "847-356-7260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3021 FALLING WATERS BLVD",
            "address_2": "SUITE A",
            "city": "LINDENHURST",
            "state": "IL",
            "postal_code": "600466793",
            "telephone_number": "847-356-9300",
            "fax_number": "847-356-7260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALVANI",
        "first_name": "THEODORE",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-20",
        "last_updated": "2010-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "25260",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036-089612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Franciscan Communities, Inc. (Victory Lakes Continuing Care Center)
• Kathryn Frazier, FNP
• Mark J Freund, DC
• Suzanne M Frings-Raftery, PHD
• Functional Theraplay Inc.
• Genrikh Gandelsman, D.D.S.
• Genrikh Gandelsman DDS MSD LTD
• Brian C. Gniadek, D.D.S.
• Richard L Goodson
• Jessica Goschy, LPC

• Emergency Medicine Physician in Lindenhurst, IL
• Providers in Lindenhurst, IL by specialty
• Emergency Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.