Santiago, Manuel D

Santiago, Manuel D is an individual health care provider with primary practice located at 7638 W North Ave , Elmwood Park IL 60707-4157. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Santiago, Manuel D can be contacted via phone (708) 452-4257.

Contact Information

Primary practice address
7638 W North Ave Elmwood Park IL 60707-4157
Phone: (708) 452-4257
Fax: (708) 452-4283
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 036082506 Illinois

Profile Details

NPI number 1154309821
LBN Legal business name Santiago, Manuel D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 4th, 2006
Last updated Jul 1st, 2010 - about 14 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 1154309821 NPPES
Illinois MEDICAID 0360825061

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