DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

RICHARD A DISANTO, PA-C

Active

RICHARD A DISANTO, PA-C is a Medical Physician Assistant healthcare provider located in LA GRANGE, Illinois. NPI 1235290883 is currently active in the NPPES registry. Verify at CMS.

Medical Physician Assistant · LA GRANGE, IL

Registration Details

NPI Number
1235290883
Provider Type
Individual
Gender
Male
NPI Issued
Dec 13, 2006 (19.706670886383 yrs)
Last Updated
Feb 25, 2013
Licenses
1046964 (IL)
085001519 (IL)

Practice Information

Address
5201 WILLOW SPRINGS RD
LA GRANGE, IL, 605256537
Browse IL providers · Browse ZIP 60525
Phone
7085790018
Fax
7085797571
Primary Specialty
Medical Physician Assistant
363AM0700X
Additional Specialty
Medical Physician Assistant
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.