Provider Demographics
NPI:1326074055
Name:PAUL SANTANGELO DPM PC
Entity Type:Organization
Organization Name:PAUL SANTANGELO DPM PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:A
Authorized Official - Last Name:SANTANGELO
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:847-470-0555
Mailing Address - Street 1:8145 N MILWAUKEE AVE
Mailing Address - Street 2:
Mailing Address - City:NILES
Mailing Address - State:IL
Mailing Address - Zip Code:60714-2828
Mailing Address - Country:US
Mailing Address - Phone:847-470-0555
Mailing Address - Fax:847-470-0019
Practice Address - Street 1:8145 N MILWAUKEE AVE
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:IL
Practice Address - Zip Code:60714-2828
Practice Address - Country:US
Practice Address - Phone:847-470-0555
Practice Address - Fax:847-470-0019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-24
Last Update Date:2015-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01632760OtherBCBS
ILCJ8801OtherRAILROAD MEDICARE
IL201491Medicare PIN
ILCJ8801OtherRAILROAD MEDICARE