MEDICARE: DR. MARTHA HINKLE PSY.D.

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	103TC0700X	Clinical Psychologist		IL

General Provider Information

NPI Number	:	1467645911
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARTHA HINKLE PSY.D.

Provider Business Mailing Address
First Line	:	412 W HINTZ RD
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60004-2439
Country	:	US
Telephone Number	:	847-577-5196
Fax Number	:	847-577-5192

Provider Business Practice Location Address
First Line	:	412 W HINTZ RD
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60004-2439
Country	:	US
Telephone Number	:	847-577-5196
Fax Number	:	847-577-5192

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

Provider Enumeration Date	:	08/18/2007
Last Update Date	:	08/18/2007

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