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General NPI Number Information
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NPI Number | 1164339628
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Entity Type | Organization
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Legal Business Name | POLARIS BEHAVIORAL HEALTH SERVICES CORPORATION
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Dates
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Enumeration Date | 08/27/2026
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Last Update Date | 08/27/2026
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Provider Practice Location Address
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Address Line | 3635 BREITWIESER LN
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City | NAPERVILLE
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State | IL
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Zip | 60564
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Country | US
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Telephone | 312-439-1741
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Fax | 708-874-8078
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Provider Business Mailing Address
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Address Line | 3635 BREITWIESER LN
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City | NAPERVILLE
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State | IL
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Zip | 60564-8225
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Country | US
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Telephone | 312-439-1741
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Fax | 708-818-6256
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. MARY-ELLEN MARTINEZ
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Credential | PSY.D
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Telephone | 312-439-1741
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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