| Luis F. Santiago, M.d., S.c. | |
|
5533 W Cermak Rd Cicero IL 60804-2236 | |
| (708) 780-7612 | |
| (708) 780-9122 |
| Full Name | Luis F. Santiago, M.d., S.c. |
|---|---|
| Speciality | Clinic/Center |
| Location | 5533 W Cermak Rd, Cicero, Illinois |
| Authorized Official Name and Position | Luis F Santiago (PRESIDENT) |
| Authorized Official Contact | 7087807612 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Luis F. Santiago, M.d., S.c. Po Box 3666 Oak Park IL 60303-3666 Ph: (708) 780-7612 | Luis F. Santiago, M.d., S.c. 5533 W Cermak Rd Cicero IL 60804-2236 Ph: (708) 780-7612 |
| NPI Number | 1154593051 |
|---|---|
| Provider Enumeration Date | 03/31/2008 |
| Last Update Date | 03/31/2008 |
| Medicare PECOS PAC ID | 0446312268 |
|---|---|
| Medicare Enrollment ID | O20090102000217 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154593051 | NPI | - | NPPES |
| 01618077 | Other | IL | BLUE CROSS BLUE SHIELD |
| L015046 | Other | IL | TRICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (Illinois) | Primary |
| Provider Name | Luis F Santiago |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871507236 PECOS PAC ID: 9739241555 Enrollment ID: I20090102000204 |
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