Individual
MR. JEFFREY PAUL MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
516 SOUTH PLEASANT STREET, PRINCETON, IL 61356-1953
(815) 875-3661
(815) 875-1925
Mailing address
516 SOUTH PLEASANT STREET, PRINCETON, IL 61356-1953
(815) 875-3661
(815) 875-1925
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038004206
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
615601
BLUE CROSS BLUE SHIELD
IL
05
—
615601
—
IL
Enumeration date
10/10/2006
Last updated
11/22/2011
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