Healthcare Provider Details

I. General information

NPI: 1497660666
Provider Name (Legal Business Name): PEARLIE B MARTIN LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 S CENTRAL AVE APT 2E
CHICAGO IL
60644-4041
US

IV. Provider business mailing address

18 S CENTRAL AVE APT 2E
CHICAGO IL
60644-4041
US

V. Phone/Fax

Practice location:
  • Phone: 773-544-0360
  • Fax:
Mailing address:
  • Phone: 773-544-0360
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number227034618
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: