# OBSTETRICS AND GYNECOLOGY CARE ASSOCIATES, S.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1932292521
- **Authorized official:** SANTIAGO JOSEPH M.D. (OWNER)
- **Authorized official phone:** (309) 662-2273

## Contact information

- **Practice address:** 1414 WOODBINE RD, BLOOMINGTON, IL 61704-2817
- **Practice address phone:** (309) 662-2273
- **Practice address fax:** (309) 662-2014
- **Mailing address:** 1414 WOODBINE RD, BLOOMINGTON, IL 61704-2817
- **Mailing address phone:** (309) 662-2273
- **Mailing address fax:** (309) 662-2014

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | 207V000000X | IL | Yes |

## Other

- **Enumeration date:** 10/02/2006
- **Last updated:** 04/11/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 193400000X | TAXONOMY | IL |
| 01 | — | CK6294 | RAILROAD MEDICARE | — |