Individual
DR. MICHAEL J MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
24600 W. 127TH ST, STE B325, PLAINFIELD, IL 60585-9502
(815) 731-9100
(815) 731-9110
Mailing address
24600 W. 127TH ST, STE B325, PLAINFIELD, IL 60585-9502
(815) 731-9100
(815) 731-9110
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036-112004
IL
2084P0800X
Psychiatry Physician
Primary
036-112004
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036112004
—
IL
01
—
2220936
BCBS
IL
Enumeration date
08/14/2006
Last updated
11/23/2010
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