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General NPI Number Information
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NPI Number | 1295611069
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Entity Type | Individual
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Provider Name | MARIANNE SANTOS
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Gender | Female
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Dates
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Enumeration Date | 08/15/2025
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Last Update Date | 08/15/2025
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Provider Practice Location Address
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Address Line | 1040 DIXIE HWY
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City | CHICAGO HEIGHTS
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State | IL
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Zip | 60411-2690
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Country | US
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Telephone | 708-754-5700
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Fax |
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Provider Business Mailing Address
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Address Line | 18221 CORK RD
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City | TINLEY PARK
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State | IL
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Zip | 60477-4709
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Country | US
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Telephone | 708-263-7786
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 070.015004
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 070015004
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 015004
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License Number State | IL
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