MEDICARE: DR. ADELE LOUISE MARTEL M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0804X	Child & Adolescent Psychiatry Physician	036119366	IL

General Provider Information

NPI Number	:	1083638191
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ADELE LOUISE MARTEL M.D.

Provider Business Mailing Address
First Line	:	225 EAST CHICAGO AVENUE BOX #10
Second Line	:	ANN & ROBERT H. LURIE CHILDREN'S HOSPITAL OF CHICAGO
City	:	CHICAGO
State	:	IL
Zip	:	60611
Country	:	US
Telephone Number	:	312-227-6650
Fax Number	:	312-227-9659

Provider Business Practice Location Address
First Line	:	225 EAST CHICAGO AVENUE BOX #10
Second Line	:	ANN & ROBERT H. LURIE CHILDREN'S HOSPITAL OF CHICAGO
City	:	CHICAGO
State	:	IL
Zip	:	60611
Country	:	US
Telephone Number	:	312-227-6650
Fax Number	:	312-227-9659

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/26/2006
Last Update Date	:	05/15/2012

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Directions to “ DR. ADELE LOUISE MARTEL M.D.” Practice Location

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