Organization
MARTINEZ VEIN CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JORGE E. MARTINEZ M.D. (OWNER)
(630) 483-0665
Entity
Organization
Contact information
Practice address
114 BARTLETT PLZ, BARTLETT, IL 60103-4234
(630) 483-0665
(630) 483-0526
Mailing address
PO BOX 8268, BARTLETT, IL 60103-8268
(630) 483-0665
(630) 483-0526
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
036099034
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36099034
—
IL
Enumeration date
12/02/2010
Last updated
12/02/2010
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