Provider Demographics
NPI:1134080559
Name:SANCHEZ, SANTIAGO JR (SLP)
Entity type:Individual
Prefix:
First Name:SANTIAGO
Middle Name:
Last Name:SANCHEZ
Suffix:JR
Gender:M
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 E MILWAUKEE ST STE 507
Mailing Address - Street 2:
Mailing Address - City:JANESVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53545-3004
Mailing Address - Country:US
Mailing Address - Phone:608-728-7774
Mailing Address - Fax:608-621-3804
Practice Address - Street 1:101 E MILWAUKEE ST STE 507
Practice Address - Street 2:
Practice Address - City:JANESVILLE
Practice Address - State:WI
Practice Address - Zip Code:53545-3004
Practice Address - Country:US
Practice Address - Phone:608-728-7774
Practice Address - Fax:608-621-3804
Is Sole Proprietor?:No
Enumeration Date:2025-11-24
Last Update Date:2025-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6769-154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist