Valley Pathology, S.C.
Organization Active NPI Anatomic Pathology & Clinical Pathology Physician · Spring Valley, IL
NPI 1194073288 · NPPES record last updated Aug 21, 2012
Key facts
- NPI
- 1194073288
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician 207ZP0102X
- License
- 036117681 (IL)
- Legal business name
- VALLEY PATHOLOGY, S.C.
- Practice address
- 600 E 1St St
St Margaret'S Hospital
Spring Valley, IL 61362-1512 - Phone
- (815) 664-1470
- Fax
- (314) 849-6395
- NPI assigned
- Aug 21, 2012
- Organization subpart
- No
Authorized official
- Name
- Dr. Eric E Santos, M.D.
- Title
- Pathologist
- Phone
- (815) 664-1470
Other NPIs on the same Medicare enrollment 1
Practitioners 6
-
Eric Eugene Santos, M.D.
-
Mario E Cote, M.D.
-
Mark Allen Fernandez, M.D.
-
Brittney L Moutray, RD LDN CDE
-
James J. Murphy, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070926000767 | IL | Part B Supplier - Clinic/Group Practice | 2365537081 |
Receives reassigned benefits from 1 practitioner 1 other NPI on this enrollment Practice locations: Spring Valley, IL |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician |
207ZP0102X | 036117681 | IL | Yes |
Addresses
Primary practice location
600 E 1St St
St Margaret'S Hospital
Spring Valley, IL 61362-1512
Mailing address
PO Box 809059
Chicago, IL 60680-9059
Phone (888) 843-8475
Other providers in Spring Valley, IL
- True Reflections Counseling, PLLC
- Richard W Twanow
- Lauren Elizabeth Uhlenhopp
- Valley Cancer Center
- Valley Oncology Centers PC
- Paul P Velamparampil
- Taylor Anne Vipond
- Craig R Whatcott
- Sydney Wilson
- Kara Wroblewski
All providers in Spring Valley, IL · Anatomic Pathology & Clinical Pathology Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 21, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.