Individual
MR. JOSEPH A SANTIAGO JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1414 WOODBINE RD, BLOOMINGTON, IL 61704-2817
(309) 662-2273
(309) 662-2014
Mailing address
1414 WOODBINE RD, BLOOMINGTON, IL 61704-2817
(309) 662-2273
(309) 662-2014
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
036101512
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036101512
—
IL
01
—
160049257
RAILROAD MEDICARE
—
Enumeration date
09/20/2005
Last updated
04/11/2018
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