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Organization
OBSTETRICS AND GYNECOLOGY CARE ASSOCIATES, S.C.
Active
Organization
OBSTETRICS AND GYNECOLOGY CARE ASSOCIATES, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANTIAGO JOSEPH M.D. (OWNER)
(309) 662-2273
Entity
Organization
Contact information
Practice address
1414 WOODBINE RD, BLOOMINGTON, IL 61704-2817
(309) 662-2273
(309) 662-2014
Mailing address
1414 WOODBINE RD, BLOOMINGTON, IL 61704-2817
(309) 662-2273
(309) 662-2014
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
207V000000X
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
193400000X
TAXONOMY
IL
01
—
CK6294
RAILROAD MEDICARE
—
Enumeration date
10/02/2006
Last updated
04/11/2018
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