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General NPI Number Information
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NPI Number | 1003059288
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Entity Type | Individual
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Provider Name | DON MARTINEZ M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/17/2009
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Last Update Date | 12/23/2024
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Provider Practice Location Address
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Address Line | 5841 S MARYLAND AVE
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City | CHICAGO
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State | IL
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Zip | 60637-1447
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Country | US
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Telephone | 773-926-8318
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Fax |
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Provider Business Mailing Address
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Address Line | 195 N HARBOR DR APT. 3406
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City | CHICAGO
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State | IL
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Zip | 60601-7514
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Country | US
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Telephone | 312-898-5548
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 036134705
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 55083-20
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License Number State | WI
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