Individual
ANDREW D MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
4650 SOUTHWEST HWY, OAK LAWN, IL 60453
(708) 424-3201
(708) 424-5001
Mailing address
4650 SOUTHWEST HWY, OAK LAWN, IL 60453
(708) 424-3201
(708) 424-5001
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
016005084
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016-005084
—
IL
01
—
480034880
RR MEDICARE
IL
01
—
7416406
AETNA
IL
Enumeration date
11/21/2005
Last updated
07/16/2008
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