Individual
EILEEN MARTINEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
800 E NORTHWEST HWY, SUITE 106, MT PROSPECT, IL 60056-3457
(630) 862-0834
Mailing address
719 EBERLY CT, PLANO, IL 60545-2217
(630) 862-0834
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149.005636
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
149.0005636
STATE OF ILLINOIS
IL
Enumeration date
02/10/2016
Last updated
04/12/2017
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