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NPI Code Detail

MEDICARE: ASHLEY CRUZ-MARTINEZ

MEDICARE: ASHLEY CRUZ-MARTINEZ
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1205767803
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASHLEY CRUZ-MARTINEZ
Provider Business Mailing Address
First Line : 3641 W LELAND AVE APT 2
Second Line :
City : CHICAGO
State : IL
Zip : 60625-6458
Country : US
Telephone Number : 312-783-8295
Fax Number :
Provider Business Practice Location Address
First Line : 3665 N BROADWAY ST
Second Line :
City : CHICAGO
State : IL
Zip : 60613-4567
Country : US
Telephone Number : 773-496-4433
Fax Number : 773-496-4430
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/25/2026
Last Update Date : 05/25/2026

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Directions to “ ASHLEY CRUZ-MARTINEZ ” Practice Location

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