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General NPI Number Information
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NPI Number | 1710861265
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Entity Type | Individual
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Provider Name | MADELYN PAIGE MARTIN PTA
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Gender | Female
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Dates
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Enumeration Date | 08/05/2025
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Last Update Date | 08/05/2025
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Provider Practice Location Address
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Address Line | 887 E WILMETTE RD
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City | PALATINE
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State | IL
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Zip | 60074-6495
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Country | US
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Telephone | 847-907-9227
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Fax |
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Provider Business Mailing Address
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Address Line | 785 RICHWOOD AVE
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City | ELGIN
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State | IL
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Zip | 60124-5718
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Country | US
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Telephone | 708-305-8327
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 160.010478
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License Number State | IL
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