Individual
MARCO ANTONIO MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1415 E STATE ST STE 800, ROCKFORD, IL 61104-2344
(779) 696-9120
(779) 696-9593
Mailing address
PO BOX 78866, MILWAUKEE, WI 53278-8866
(779) 696-7150
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
036-157747
IL
207V00000X
Obstetrics & Gynecology Physician
4301112822
MI
Other
Enumeration date
06/08/2017
Last updated
08/31/2021
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