Individual
MARIEL MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
225 E CHICAGO AVE, CHICAGO, IL 60611-2991
(928) 446-3024
Mailing address
715 LAMON AVE, WILMETTE, IL 60091-2017
(928) 446-3024
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
209024231
IL
363LP0200X
Pediatric Nurse Practitioner
AP60733119
WA
Other
Enumeration date
02/13/2017
Last updated
05/31/2022
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