Provider Demographics
NPI:1093773855
Name:SANTIAGO, MARIA M (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:M
Last Name:SANTIAGO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MARIA
Other - Middle Name:MEDALINE
Other - Last Name:SANTIAGO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:3325 N ARLINGTON HEIGHTS RD
Mailing Address - Street 2:SUITE 100A
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60004-1582
Mailing Address - Country:US
Mailing Address - Phone:847-398-0400
Mailing Address - Fax:847-398-9590
Practice Address - Street 1:3325 N ARLINGTON HEIGHTS RD
Practice Address - Street 2:SUITE 100A
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004-1582
Practice Address - Country:US
Practice Address - Phone:847-398-0400
Practice Address - Fax:847-398-9590
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036103158208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics