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Organization
RUBEN E SANTOS, MD, SC
Active
Organization
RUBEN E SANTOS, MD, SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ERIC E SANTOS M.D. (PATHOLOGIST)
(815) 664-1470
Entity
Organization
Contact information
Practice address
600 E 1ST ST, ST MARGARET'S HOSPITAL, SPRING VALLEY, IL 61362-1512
(815) 664-1470
(314) 849-6395
Mailing address
PO BOX 809059, CHICAGO, IL 60680-9059
(888) 843-8475
(314) 849-6395
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
036117681
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0360465101
—
IL
01
—
1114110780
NPI GROUP NUMBER
IL
01
—
1255382230
INDIVIDUAL NPI
IL
01
—
14D0431111
CLIA
IL
01
—
215550
MEDICARE GROUP NUMBER
IL
01
—
220001540
RR MEDICARE
IL
Enumeration date
08/27/2007
Last updated
04/30/2008
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