Individual
DR. MATTHEW L MARTENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3700 W 203RD ST STE 201, OLYMPIA FIELDS, IL 60461-1182
(708) 679-2120
(708) 503-3230
Mailing address
360 W ILLINOIS ST APT 501, CHICAGO, IL 60654-5280
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
20A10803
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036129770
ILLINOIS
IL
01
—
203979048
MEDICARE PTAN
IL
01
—
20A10803
CA MEDICAL LICENSE
CA
Enumeration date
06/24/2009
Last updated
11/15/2023
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