Basic Information
Provider Information
NPI: 1366869570
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GALEANO
FirstName: XOCHIL
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 500 W BELMONT AVE APT 6A
Address2:  
City: CHICAGO
State: IL
PostalCode: 606574643
CountryCode: US
TelephoneNumber: 7864170206
FaxNumber:  
Practice Location
Address1: 7222 W CERMAK RD STE 718
Address2:  
City: NORTH RIVERSIDE
State: IL
PostalCode: 605461423
CountryCode: US
TelephoneNumber: 3129423034
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/25/2014
LastUpdateDate: 07/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208000000X036-413513ILY Allopathic & Osteopathic PhysiciansPediatrics 

No ID Information.


Home