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Individual

ELIZABETH G MARTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ACNP

Contact information

Practice address
5841 S MARYLAND AVE, CHICAGO, IL 60637-1447
(708) 209-7256
Mailing address
5643 W PAULING RD, MONEE, IL 60449-9545
(708) 209-7256

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
209009871
IL

Other

Enumeration date
10/04/2012
Last updated
10/04/2012
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