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NPI Code Detail

MEDICARE: DIEGO MARTINEZ RPH

MEDICARE:   DIEGO  MARTINEZ  RPH
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
1183500000XPharmacist051292190IL

General Provider Information

NPI Number : 1124301346
Entity Type Code : Individual
Provider Name (Legal Business Name) : DIEGO MARTINEZ RPH
Provider Business Mailing Address
First Line : 2146 N DAYTON ST APT 108
Second Line :
City : CHICAGO
State : IL
Zip : 60614
Country : US
Telephone Number : 630-440-6943
Fax Number :
Provider Business Practice Location Address
First Line : 2146 N DAYTON ST APT 108
Second Line :
City : CHICAGO
State : IL
Zip : 60614-4389
Country : US
Telephone Number : 630-440-6943
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/23/2011
Last Update Date : 09/23/2011

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Directions to “ DIEGO MARTINEZ RPH” Practice Location

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