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Organization
MARTIN J. SZANTO, M.D., S.C.
Active
Organization
MARTIN J. SZANTO, M.D., S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY MILLER (DIRECTOR OF RCM)
(248) 331-7908
Entity
Organization
Contact information
Practice address
6374 N LINCOLN AVE, SUITE 201, CHICAGO, IL 60659-1275
(773) 539-4145
(773) 539-1207
Mailing address
6374 N LINCOLN AVE, SUITE 201, CHICAGO, IL 60659-1275
(773) 539-4145
(773) 539-1207
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036039841
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0021608067
BLUE CROSS PROVIDER
IL
05
—
036039841
—
IL
01
—
111910408
RAILROAD MEDICARE
IL
01
—
1629059902
INDIVIDUAL NPI
IL
01
—
466180
MEDICARE PROVIDER
IL
01
—
K46072
MEDICARE PTAN
IL
Enumeration date
11/02/2007
Last updated
12/13/2023
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