Martin, Michael J

Martin, Michael J is an individual health care provider with primary practice located at 24600 W. 127Th St Ste B325, Plainfield IL 60585-9502. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Psychiatry. Allopathic & Osteopathic Physicians / Psychiatry is his primary health care specialty. Martin, Michael J can be contacted via phone (815) 731-9100.

Contact Information

Primary practice address
24600 W. 127Th St Ste B325 Plainfield IL 60585-9502
Phone: (815) 731-9100
Fax: (815) 731-9110
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 036-112004 Illinois
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 036-112004 Illinois

Profile Details

NPI number 1962415513
LBN Legal business name Martin, Michael J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 14th, 2006
Last updated Nov 23rd, 2010 - about 14 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962415513 NPPES
Illinois MEDICAID 036112004
Illinois Other 2220936

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