Individual
STEPHANIE MARTINEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1820 N TRIPP AVE, CHICAGO, IL 60639-4860
(312) 730-2894
Mailing address
1820 N TRIPP AVE, CHICAGO, IL 60639-4860
(312) 730-2894
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
227015912
IL
363A00000X
Physician Assistant
Primary
085.012086
IL
Other
Enumeration date
06/10/2021
Last updated
04/21/2026
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