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NPI Code Detail

MEDICARE: MARTENS CHIROPRACTIC AND ACUPUNCTURE CENTER, S.C.

MEDICARE: MARTENS CHIROPRACTIC AND ACUPUNCTURE CENTER, S.C.
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
1111N00000XChiropractorIL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12232917OTHERILBCBS NUMBER

General Provider Information

NPI Number : 1205910247
Entity Type Code : Organization
Provider Name (Legal Business Name) : MARTENS CHIROPRACTIC AND ACUPUNCTURE CENTER, S.C.
Provider Business Mailing Address
First Line : 7511 LEMONT RD
Second Line : SUITE 150
City : DARIEN
State : IL
Zip : 60561-4394
Country : US
Telephone Number : 630-985-7700
Fax Number : 630-985-7800
Provider Business Practice Location Address
First Line : 7511 LEMONT RD
Second Line : SUITE 150
City : DARIEN
State : IL
Zip : 60561-4394
Country : US
Telephone Number : 630-985-7700
Fax Number : 630-985-7800
Authorized Official
Title or Position : PRESIDENT
Name : DR. KATHLEEN A MARTENS
Credential : DC
Telephone Number : 630-985-7700
Provider Enumeration Date : 10/25/2006
Last Update Date : 08/22/2020

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