Individual
MISS MARISOL MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2500 W 46TH PL, CHICAGO, IL 60632-1334
(773) 971-5192
Mailing address
2500 W 46TH PL, CHICAGO, IL 60632-1334
(773) 971-5192
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
041463182
IL
367500000X
Certified Registered Nurse Anesthetist
Primary
209030336
IL
Other
Enumeration date
08/26/2022
Last updated
05/08/2025
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