Individual
MR. GREGORY LEE MARTINDILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
3101 FIELDS SOUTH DR, CHAMPAIGN, IL 61822-3743
(217) 366-6162
(217) 366-6106
Mailing address
101 W UNIVERSITY AVE, CHAMPAIGN, IL 61820-3909
(217) 366-6162
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
85000525
IL
Other
Enumeration date
09/06/2005
Last updated
01/05/2022
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