Organization
STEVEN J. DISANTI D.O. S.C.
Active
Other names
D/B/A Genoa Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEVEN J DISANTI D.O. (PRESIDENT)
(815) 784-5188
Entity
Organization
Contact information
Practice address
109 S GENOA ST, GENOA, IL 60135-1120
(815) 784-5188
(815) 784-5189
Mailing address
109 S GENOA ST, GENOA, IL 60135-1120
(815) 784-5188
(815) 784-5189
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
IL
208D00000X
General Practice Physician
Primary
—
IL
Other
Enumeration date
07/24/2006
Last updated
12/10/2007
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