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NPI Code Detail

MEDICARE: MARIE-ANNE SANTANA N.P

MEDICARE:   MARIE-ANNE  SANTANA  N.P
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
1363LW0102XWomen's Health Nurse PractitionerIL

General Provider Information

NPI Number : 1861694184
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIE-ANNE SANTANA N.P
Provider Business Mailing Address
First Line : 851 N KEELER AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60651-3502
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2861 N CLARK ST
Second Line :
City : CHICAGO
State : IL
Zip : 60657-5207
Country : US
Telephone Number : 312-744-5507
Fax Number : 312-744-2573
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/31/2007
Last Update Date : 07/08/2007

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Directions to “ MARIE-ANNE SANTANA N.P” Practice Location

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