Martin, Lisa
Martin, Lisa is an individual health care provider with primary practice located at 636 Raymond Dr Suite 205, Naperville IL 60563-9789. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Martin, Lisa can be contacted via phone (630) 717-2300.Contact Information
Primary practice address
636 Raymond Dr Suite 205
Naperville IL 60563-9789
Phone: (630) 717-2300
Fax: (630) 717-9638
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 36102079 | Illinois |
Profile Details
| NPI number | 1245204122 |
|---|---|
| LBN Legal business name | Martin, Lisa |
| Credentials | MD MPH |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 15th, 2006 |
| Last updated | Oct 29th, 2013 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1245204122 | NPPES |
| Illinois | MEDICAID | 36102079 |
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