MEDICARE: FAMILY MEDICAL & AESTHETICS, LLC

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	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1578410031
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY MEDICAL & AESTHETICS, LLC

Provider Business Mailing Address
First Line	:	4143 JOLIET AVE
Second Line	:
City	:	LYONS
State	:	IL
Zip	:	60534-2070
Country	:	US
Telephone Number	:	708-484-9145
Fax Number	:

Provider Business Practice Location Address
First Line	:	7036 CERMAK RD
Second Line	:
City	:	BERWYN
State	:	IL
Zip	:	60402-2197
Country	:	US
Telephone Number	:	708-484-9145
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JAIME MARTINEZ
Credential	:	RN
Telephone Number	:	708-712-2151

Provider Enumeration Date	:	03/13/2026
Last Update Date	:	03/13/2026

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