Healthcare Provider Details

I. General information

NPI: 1568376556
Provider Name (Legal Business Name): BIANNEY MARTINEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3030 W SALT CREEK LN
ARLINGTON HEIGHTS IL
60005-5001
US

IV. Provider business mailing address

3096 WAKEFIELD DR
CARPENTERSVILLE IL
60110-2441
US

V. Phone/Fax

Practice location:
  • Phone: 877-486-4140
  • Fax: 847-253-3912
Mailing address:
  • Phone: 224-368-0261
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: