OrganizationActive
Ma. Olivia R. San Diego, M.D., S.c.
NPI 1245580653 · Pediatrics Physician · Chicago, IL
Provider details
- NPI number
- 1245580653
- Entity type
- Organization
- Primary specialty
- Pediatrics PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Ma. Olivia San Diego, Director(973) 653-6119
- License
- 036-130487 (IL)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(79/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
13 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1044 N Mozart St
Suite 205
Chicago, IL 60622-2789
Phone: (773) 489-2913
Fax: (773) 489-7330
Street-level locationGet directions
Mailing address
1044 N Mozart St
Chicago, IL 60622-2789
Registry dates
- Enumerated
- 2012-09-12
- Last updated
- 2012-09-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.