Individual
MANUEL D SANTIAGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7638 W NORTH AVE, ELMWOOD PARK, IL 60707-4157
(708) 452-4257
(708) 452-4283
Mailing address
7638 W NORTH AVE, ELMWOOD PARK, IL 60707-4157
(708) 452-4257
(708) 452-4283
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
036082506
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0360825061
—
IL
Enumeration date
01/04/2006
Last updated
07/01/2010
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