| Organization Name: | GALILEE MEDICAL CENTER S.C. |
| NPI Number: | 1437104239 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | NASER RUSTOM (OWNER) |
| Mailing Address: | 4941 N. Kedzie Ave Chicago |
| State: | IL US |
| Postal Code: | 60625 |
| Phone Number: | 7735099099 |
| Fax Number: | 7735099006 |
| NPI Enumeration Date: | 05/23/2006 |
| NPI Last Update Date: | 03/04/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 042-616-998 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |