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General NPI Number Information
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NPI Number | 1770452583
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Entity Type | Individual
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Provider Name | MARTINA KOTRBA PA
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Gender | Female
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Dates
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Enumeration Date | 10/30/2025
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Last Update Date | 10/30/2025
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Provider Practice Location Address
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Address Line | 1050 E NORRIS DR STE 1C
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City | OTTAWA
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State | IL
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Zip | 61350-1608
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Country | US
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Telephone | 815-239-6308
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Fax |
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Provider Business Mailing Address
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Address Line | 1204 EMINGTON LN
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City | MINOOKA
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State | IL
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Zip | 60447-4542
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Country | US
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Telephone | 773-590-0771
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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 | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 085.011653
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License Number State | IL
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