Individual
DR. MARTIN R HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3330 WEST 177TH ST, SUITE 2C, HAZEL CREST, IL 60429
(708) 799-1144
(708) 799-4899
Mailing address
3330 WEST 177TH ST, SUITE 2C, HAZEL CREST, IL 60429
(708) 799-1144
(708) 799-4899
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
01036580A
IN
207X00000X
Orthopaedic Surgery Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000095624
ANTHEM BCBS
IN
01
—
31603346
BCBS
IL
01
—
36379809016898
ADVOCATE
—
01
—
4339671
AETNA
—
01
—
DD9203
RR MEDICARE
IL
01
—
DE2045
RR MEDICARE
IN
Enumeration date
04/05/2006
Last updated
02/13/2008
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