Individual
DR. MARTHA MENCHACA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
611 W PARK, FAPC, CHAMPAIGN, IL 61802
(217) 902-6954
(217) 902-7711
Mailing address
611 W PARK, FAPC, CHAMPAIGN, IL 61802
(217) 902-6954
(217) 902-7711
Taxonomy
Speciality
Code
Description
License number
State
2085D0003X
Diagnostic Neuroimaging (Radiology) Physician
036.111975
IL
2085R0202X
Diagnostic Radiology Physician
Primary
036.111975
IL
2085R0202X
Diagnostic Radiology Physician
224444
MA
Other
Enumeration date
11/08/2005
Last updated
05/20/2025
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