Sandiego, Anthony L

Sandiego, Anthony L is an individual health care provider with primary practice located at 1 Doctors Park , Gibson City IL 60936-2000. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Sandiego, Anthony L can be contacted via phone (217) 784-4297.

Contact Information

Primary practice address
1 Doctors Park Gibson City IL 60936-2000
Phone: (217) 784-4297
Fax: (217) 784-4697
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 036104575 Illinois

Profile Details

NPI number 1215935895
LBN Legal business name Sandiego, Anthony L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 8th, 2005
Last updated Dec 21st, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1215935895 NPPES
Other 370647938 FEIN
Other 02727758 FEIN
MEDICAID 036104575 FEIN

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