MEDICARE: RICARDO MARTINEZ MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	036087720	IL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	08143606	OTHER	IL	MEDICARE RR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033307863
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICARDO MARTINEZ MD

Provider Business Mailing Address
First Line	:	4201 WINFIELD RD FL 4
Second Line	:
City	:	WARRENVILLE
State	:	IL
Zip	:	60555-4025
Country	:	US
Telephone Number	:	331-221-6377
Fax Number	:	331-221-2357

Provider Business Practice Location Address
First Line	:	303 W LAKE ST STE 200
Second Line	:
City	:	ADDISON
State	:	IL
Zip	:	60101-2500
Country	:	US
Telephone Number	:	331-221-9001
Fax Number	:	331-221-3971

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/05/2007
Last Update Date	:	05/04/2021

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Directions to “ RICARDO MARTINEZ MD” Practice Location

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