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General NPI Number Information
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NPI Number | 1487779468
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Entity Type | Organization
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Legal Business Name | MARTIN LEMON, PHD, P.C.
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Dates
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Enumeration Date | 03/20/2007
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Last Update Date | 10/06/2016
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Provider Practice Location Address
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Address Line | 28379 DAVIS PKWY SUITE 801
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City | WARRENVILLE
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State | IL
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Zip | 60555-3032
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Country | US
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Telephone | 630-393-9800
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Fax | 630-393-0499
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Provider Business Mailing Address
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Address Line | 28379 DAVIS PKWY SUITE 801
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City | WARRENVILLE
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State | IL
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Zip | 60555-3032
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Country | US
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Telephone | 630-393-9800
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Fax | 630-393-0499
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Authorized Official
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Title or Position | OWNER
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Name | DR. MARTIN EDWARD LEMON
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Credential | PH.D.
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Telephone | 630-393-9800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 071-004794
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License Number State | IL
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