Organization
GALILEE MEDICAL CENTER, S.C.
Active
Other names
MRI LINCOLN IMAGING CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NASER RUSTOM (PRESIDENT)
(773) 237-0755
Entity
Organization
Contact information
Practice address
4849 W FULLERTON AVE, CHICAGO, IL 60639-2503
(773) 622-1200
(773) 622-1211
Mailing address
4200 W 63RD ST, SUITE A, CHICAGO, IL 60629-5010
(773) 581-5600
(773) 581-5608
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
042619832
IL
Other
Enumeration date
07/07/2015
Last updated
07/10/2015
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