Santiago Fabian Moscoso Martinez M.D.

NPI 1154619021 - Internal Medicine - 207R00000X

NPI Details
NPI 1154619021
Gender Male
Enumeration Date 07/13/2011
Last Updated 07/13/2011
Entity Type Individual
Active Over 5 years ago
Practice Location
836 W WELLINGTON AVE
CHICAGO IL, 60657-5147, US
Phone (773) 296-7046
Fax
Business Location
856 W NELSON ST APT 1208
CHICAGO IL, 60657-9205, US
Phone (312) 898-9112
Fax
Toxanomy
Taxonomy Code 207R00000X
License State Illinois
License Number 125060325
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According to our database, Dr. Santiago Fabian Moscoso Martinez M.D. NPI is 1154619021, taxonomy code is 207R00000X and license number is 125060325, license state is located at Illinois. Santiago Fabian Moscoso Martinez M.D. physically located at 836 W Wellington Ave, Chicago IL, 60657-5147. NPI Number Santiago Fabian Moscoso Martinez M.D. has the Individual type.

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1154619021 NPI number is provided on an as is basis without warranty of any kind. 1154619021 is maintained by the National Plan & Provider Enumeration System. The contents of Santiago Fabian Moscoso Martinez M.D. are for informational purposes only.