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General NPI Number Information
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NPI Number | 1801089016
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Entity Type | Individual
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Provider Name | JUAN ALBERTO SANTIAGO-GONZALEZ MD
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Gender | Male
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Dates
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Enumeration Date | 08/21/2007
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Last Update Date | 05/13/2022
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Provider Practice Location Address
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Address Line | 836 W WELLINGTON AVE RM 4813CC
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City | CHICAGO
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State | IL
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Zip | 60657-5147
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Country | US
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Telephone | 773-296-5073
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Fax | 773-296-7199
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Provider Business Mailing Address
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Address Line | 29373 NETWORK PL
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City | CHICAGO
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State | IL
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Zip | 60673-1293
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Country | US
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Telephone | 847-390-5900
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 12893
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number | 036125266
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 2086S0127X
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Taxonomy Name | Trauma Surgery Physician
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License Number | 036.125266
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 036.125266
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License Number State | IL
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