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NPI Code Detail

MEDICARE: MARTINA V CORTEZ MS, LCPC

MEDICARE: MARTINA V CORTEZ MS, LCPC
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
1101YP2500XProfessional Counselor180005565IL

General Provider Information

NPI Number : 1831109263
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARTINA V CORTEZ MS, LCPC
Provider Business Mailing Address
First Line : 1205 DEERFIELD PKWY
Second Line : APT 302
City : BUFFALO GROVE
State : IL
Zip : 60089-4559
Country : US
Telephone Number : 847-933-0051
Fax Number : 847-933-0057
Provider Business Practice Location Address
First Line : 8324 SKOKIE BLVD
Second Line :
City : SKOKIE
State : IL
Zip : 60077-2545
Country : US
Telephone Number : 847-933-0051
Fax Number : 847-933-0057
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/08/2006
Last Update Date : 11/03/2009

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Directions to “ MARTINA V CORTEZ MS, LCPC” Practice Location

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