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Individual

EDDY SANTOS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CAC

Contact information

Practice address
1111 W LAKE ST, ADDISON, IL 60101-1197
(630) 221-5305
(630) 510-5464
Mailing address
111 N COUNTY FARM RD, WHEATON, IL 60187-3988
(630) 221-5305
(630) 510-5464

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
172V00000X
Community Health Worker
17082198
IL

Other

Enumeration date
02/03/2020
Last updated
02/06/2020
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