Organization
MARTIN R HALL MD. SC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN P HERTEL (OPERATIONS MANAGER)
(708) 799-1144
Entity
Organization
Contact information
Practice address
3330 W 177TH ST, SUITE 2C, HAZEL CREST, IL 60429-2184
(708) 799-1144
(708) 799-4899
Mailing address
3330 W 177TH ST, SUITE 2C, HAZEL CREST, IL 60429-2184
(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
—
31603346
BCBS
IL
01
—
DD9203
RAILROAD MEDICARE
IL
01
—
DE2045
RAILROAD MEDICARE
IN
Enumeration date
07/03/2007
Last updated
02/13/2008
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