Individual
DR. JUAN ALBERTO SANTIAGO-GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
836 W WELLINGTON AVE RM 4813CC, CHICAGO, IL 60657-5147
(773) 296-5073
(773) 296-7199
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1293
(847) 390-5900
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
036.125266
IL
208600000X
Surgery Physician
12893
PR
2086S0102X
Surgical Critical Care Physician
036125266
IL
2086S0127X
Trauma Surgery Physician
036.125266
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036125266
STATE LICENSE
IL
Enumeration date
08/21/2007
Last updated
05/13/2022
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