Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | 036144097 | IL |
NPI | 1013301126 |
---|---|
Provider Name | Phillip Pasquale Santoiemma |
First Address | Chicago, IL 60611-2945 |
Second Address | Chicago, IL 60611-2945 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2015 |
Last Update Date | 21/12/2021 |