MEDICARE: MR. KENNETH MICHAEL MARTIN DC

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	111N00000X	Chiropractor	38010989	IL

General Provider Information

NPI Number	:	1689872509
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. KENNETH MICHAEL MARTIN DC

Provider Business Mailing Address
First Line	:	4177 S ARCHER AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60632-1849
Country	:	US
Telephone Number	:	773-254-2222
Fax Number	:

Provider Business Practice Location Address
First Line	:	4177 S ARCHER AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60632-1849
Country	:	US
Telephone Number	:	773-254-2222
Fax Number	:

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

Provider Enumeration Date	:	07/03/2007
Last Update Date	:	02/10/2009

Similar Medicare Providers

1407960032 — STEVEN ALLEN BLACKWELL PH.D., J.D., R.PH.
Practice Location Address:

7500 SECURITY BLVD # C3-20-17 , CENTERS FOR MEDICARE & MEDICAID SERVICES
BALTIMORE, MD
21244-1849

Practice Phone: 410-786-6852
Practice Fax:

1790573681 — SZU-HSIEN CHEN AGPCNP-BC
Practice Location Address:

4177 S ARCHER AVE
CHICAGO, IL
60632-1849

Practice Phone: 773-254-2222
Practice Fax:

1992817191 — A. K. MATHEW M.D.
Practice Location Address:

4177 S ARCHER AVE
CHICAGO, IL
60632-1849

Practice Phone: 773-254-2222
Practice Fax: 773-254-8444

1366681025 — MARQUE MEDICOS ARCHER, LLC
Practice Location Address:

4195 S ARCHER AVE
CHICAGO, IL
60632-1849

Practice Phone: 773-283-3131
Practice Fax: 773-283-3610

1831333814 — DR. HARVEEN KAUR SOODAN M.D.
Practice Location Address:

4177 S ARCHER AVE
CHICAGO, IL
60632-1849

Practice Phone: 773-254-2222
Practice Fax:

1245507839 — CICELY SIMONE BROOKS PA- C
Practice Location Address:

4177 S ARCHER AVE
CHICAGO, IL
60632-1849

Practice Phone: 773-932-1142
Practice Fax:

Directions to “ MR. KENNETH MICHAEL MARTIN DC” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.