Individual
MARTHA C LINDSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
731 S. IL-21, STE 110, GURNEE, IL 60031-3204
(847) 360-8440
Mailing address
111 E WISCONSIN AVE, SUITE 2000, MILWAUKEE, WI 53202-4815
(414) 290-6720
(414) 290-6755
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209-008244
IL
363L00000X
Nurse Practitioner
41341644
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1861706160
TRICARE NORTH REGION
IL
01
—
P00932260
MEDICARE RAILROAD
IL
Enumeration date
07/29/2010
Last updated
12/05/2024
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