Provider Demographics
NPI:1508900366
Name:GALASSI, WILLIAM VINCENT (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:VINCENT
Last Name:GALASSI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 N WATERMAN AVE
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60004-6464
Mailing Address - Country:US
Mailing Address - Phone:847-577-7211
Mailing Address - Fax:
Practice Address - Street 1:1320 N HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60506-1467
Practice Address - Country:US
Practice Address - Phone:630-859-8159
Practice Address - Fax:630-859-8474
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-16
Last Update Date:2011-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-060014207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILC44783Medicare UPIN