Healthcare Provider Details

I. General information

NPI: 1386082428
Provider Name (Legal Business Name): ANUJA MARTINEZ LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2013
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9324 CHESTNUT TRL
TINLEY PARK IL
60487-5306
US

IV. Provider business mailing address

9324 CHESTNUT TRL
TINLEY PARK IL
60487-5306
US

V. Phone/Fax

Practice location:
  • Phone: 773-991-2146
  • Fax:
Mailing address:
  • Phone: 773-991-2146
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149014784
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: