| Steven J. Disanti D.o. S.c. | |
|
109 S Genoa St Genoa IL 60135-1120 | |
| (815) 784-5188 | |
| (815) 784-5189 |
| Full Name | Steven J. Disanti D.o. S.c. |
|---|---|
| Speciality | General Practice |
| Location | 109 S Genoa St, Genoa, Illinois |
| Authorized Official Name and Position | Steven J Disanti (PRESIDENT) |
| Authorized Official Contact | 8157845188 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Steven J. Disanti D.o. S.c. 109 S Genoa St Genoa IL 60135-1120 Ph: (815) 784-5188 | Steven J. Disanti D.o. S.c. 109 S Genoa St Genoa IL 60135-1120 Ph: (815) 784-5188 |
| NPI Number | 1013939602 |
|---|---|
| Provider Enumeration Date | 07/24/2006 |
| Last Update Date | 12/10/2007 |
| Medicare PECOS PAC ID | 1052312576 |
|---|---|
| Medicare Enrollment ID | O20070126000225 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013939602 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Illinois) | Secondary |
| 208D00000X | General Practice | (Illinois) | Primary |
| Provider Name | Steven J Disanti |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1578582474 PECOS PAC ID: 6305813619 Enrollment ID: I20080218000592 |
Family First Physicians Sc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 599 Pearson Dr, Genoa, IL 60135 Phone: 815-784-6300 Fax: 815-784-6363 |