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NPI Code Detail

MEDICARE: GERALD SANTANGELO APRN, FNP

MEDICARE: GERALD SANTANGELO APRN, FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner209.019150IL

General Provider Information

NPI Number : 1578127684
Entity Type Code : Individual
Provider Name (Legal Business Name) : GERALD SANTANGELO APRN, FNP
Provider Business Mailing Address
First Line : 504 S BEVERLY LN
Second Line :
City : ARLINGTON HEIGHTS
State : IL
Zip : 60005-2104
Country : US
Telephone Number : 847-707-1806
Fax Number :
Provider Business Practice Location Address
First Line : 1276 N CLYBOURN AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60610-2003
Country : US
Telephone Number : 312-337-1073
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/24/2019
Last Update Date : 04/24/2019

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