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NPI Code Detail

MEDICARE: GISELLE MARTINEZ-O'CONNOR MSN, APRN, FNP-BC

MEDICARE: GISELLE MARTINEZ-O'CONNOR MSN, APRN, FNP-BC
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
1363L00000XNurse Practitioner277005408IL
2363LF0000XFamily Nurse Practitioner277005408IL

General Provider Information

NPI Number : 1447801998
Entity Type Code : Individual
Provider Name (Legal Business Name) : GISELLE MARTINEZ-O'CONNOR MSN, APRN, FNP-BC
Provider Business Mailing Address
First Line : 17800 KEDZIE AVE
Second Line :
City : HAZEL CREST
State : IL
Zip : 60429-2029
Country : US
Telephone Number : 708-799-8000
Fax Number : 773-967-5808
Provider Business Practice Location Address
First Line : 1740 W TAYLOR ST
Second Line :
City : CHICAGO
State : IL
Zip : 60612-7232
Country : US
Telephone Number : 312-996-4008
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/26/2019
Last Update Date : 06/01/2026

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