Individual
DEANNA B. S. MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
251 E HURON, FEINBERG 16-738, CHICAGO, IL 60611
(312) 926-5924
(312) 926-6134
Mailing address
680 N LAKE SHORE DR, SUITE #1000, CHICAGO, IL 60611-4546
(312) 695-0665
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
085005106
IL
363AM0700X
Medical Physician Assistant
Primary
085005106
IL
Other
Enumeration date
07/25/2014
Last updated
07/26/2018
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