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General NPI Number Information
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NPI Number | 1871621136
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Entity Type | Individual
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Provider Name | LATA SANTA INES MD
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Gender | Female
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Dates
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Enumeration Date | 03/01/2007
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 373 SUMMIT ST SUITE 105
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City | ELGIN
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State | IL
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Zip | 60120
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Country | US
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Telephone | 847-888-3631
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Fax |
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Provider Business Mailing Address
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Address Line | 3351 SANDSTONE CT
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City | LAKE IN THE HILLS
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State | IL
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Zip | 60156-4425
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Country | US
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Telephone | 224-231-7335
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 49654
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 8671780
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License Number State | ID
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Taxonomy #3
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | ME151048
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License Number State | FL
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