Individual
DR. ESTELLA FAVIOLA MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3550 E 118TH ST, CHICAGO, IL 60617-7314
(773) 646-9800
Mailing address
3550 E 118TH ST, CHICAGO, IL 60617-7314
(773) 646-9800
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036-117092
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036-117092
STATE LICENSE
IL
Enumeration date
02/23/2007
Last updated
10/04/2016
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