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Individual
DR. ERIC EUGENE SANTOS
Active
Individual
DR. ERIC EUGENE SANTOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
036.117681
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036.117681
IL STATE LICENSE NUMBER
IL
01
—
1114110780
GROUP NPI
IL
01
—
14D0431111
CLIA
IL
01
—
215550
MEDICARE GROUP NUMBER
IL
01
—
615604
BSCHI
IL
Enumeration date
05/09/2007
Last updated
05/02/2008
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