Healthcare Provider Details

I. General information

NPI: 1720639008
Provider Name (Legal Business Name): ESMERALDA MARTINEZ APN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/26/2019
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 E ARMY TRAIL RD STE 310
BLOOMINGDALE IL
60108-2138
US

IV. Provider business mailing address

201 E ARMY TRAIL RD STE 310
BLOOMINGDALE IL
60108-2138
US

V. Phone/Fax

Practice location:
  • Phone: 630-808-9387
  • Fax:
Mailing address:
  • Phone: 630-808-9387
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number277004115
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209.020125
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: