MEDICARE: CHERYL MARTINEZ PMHNP

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	209031896	IL

General Provider Information

NPI Number	:	1700685708
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHERYL MARTINEZ PMHNP

Provider Business Mailing Address
First Line	:	2314 S ROUTE 59 UNIT 164
Second Line	:
City	:	PLAINFIELD
State	:	IL
Zip	:	60586-7756
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2314 S ROUTE 59 UNIT 164
Second Line	:
City	:	PLAINFIELD
State	:	IL
Zip	:	60586-7756
Country	:	US
Telephone Number	:	708-986-0207
Fax Number	:

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

Provider Enumeration Date	:	03/11/2025
Last Update Date	:	10/21/2025

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