Provider Demographics
NPI:1710944111
Name:SANTOS, SYLVIA AGTARAP (PSYCHIATRY)
Entity Type:Individual
Prefix:DR
First Name:SYLVIA
Middle Name:AGTARAP
Last Name:SANTOS
Suffix:
Gender:F
Credentials:PSYCHIATRY
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Mailing Address - Street 1:333 S STATE STREET REVENUE 200
Mailing Address - Street 2:CHICAGO DEPARTMENT OF PUBLIC HEALTH
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60604
Mailing Address - Country:US
Mailing Address - Phone:312-747-9443
Mailing Address - Fax:312-747-9447
Practice Address - Street 1:333 S STATE STREET REVENUE 200
Practice Address - Street 2:CHICAGO DEPARTMENT OF PUBLIC HEALTH
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60604
Practice Address - Country:US
Practice Address - Phone:312-747-9443
Practice Address - Fax:312-747-9447
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
F64159Medicare UPIN
280680Medicare ID - Type Unspecified