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NPI Code Detail

MEDICARE: SUSAN MARTINEZ

MEDICARE: SUSAN MARTINEZ
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1760074835
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN MARTINEZ
Provider Business Mailing Address
First Line : 1400 S AUSTIN BLVD
Second Line :
City : CICERO
State : IL
Zip : 60804-1003
Country : US
Telephone Number : 708-299-3239
Fax Number :
Provider Business Practice Location Address
First Line : 1400 S AUSTIN BLVD
Second Line :
City : CICERO
State : IL
Zip : 60804-1003
Country : US
Telephone Number : 708-299-3239
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/09/2021
Last Update Date : 02/09/2021

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Directions to “ SUSAN MARTINEZ ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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