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General NPI Number Information
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NPI Number | 1154593051
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Entity Type | Organization
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Legal Business Name | LUIS F. SANTIAGO, M.D., S.C.
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Dates
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Enumeration Date | 03/31/2008
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Last Update Date | 09/18/2025
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Provider Practice Location Address
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Address Line | 5533 W CERMAK RD
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City | CICERO
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State | IL
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Zip | 60804-2236
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Country | US
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Telephone | 708-780-7612
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Fax | 708-780-9122
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Provider Business Mailing Address
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Address Line | PO BOX 3666
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City | OAK PARK
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State | IL
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Zip | 60303-3666
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Country | US
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Telephone | 708-780-7612
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Fax | 708-780-9122
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LUIS F SANTIAGO
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Credential | MD
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Telephone | 708-780-7612
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State | IL
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