Individual
MS. TEDJITOU MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
6436 ROOSEVELT RD, 307, OAK PARK, IL 60304-2163
(708) 655-9606
Mailing address
6436 ROOSEVELT RD, 307, OAK PARK, IL 60304-2163
(708) 655-9606
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
085-002895
IL
363A00000X
Physician Assistant
085.002895
IL
Other
Enumeration date
02/14/2007
Last updated
04/28/2009
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