Individual
DR. JUSTIN TROY MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1969 W OGDEN AVE, CHICAGO, IL 60612-3765
(208) 577-0326
Mailing address
430 W DIVERSEY PKWY APT 208, CHICAGO, IL 60614-6124
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
125071377
IL
Other
Enumeration date
06/30/2017
Last updated
01/20/2022
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