Charles Franklin Martin I, MD, FACEP

Key facts

NPI

1083674170

Entity type

Individual (NPI type 1)

Primary specialty

Vascular Surgery Physician 2086S0129X

License

036087693 (IL)

Practice address

9501 W 144TH PL
Suite 304
Orland Park, IL 60462-2561

Phone

(708) 873-3450

Fax

(708) 873-2791

NPI assigned

Mar 24, 2006

Sex

Male

Sole proprietor

No

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Hoopeston Community Memorial Hospital Internal Medicine Physician · Hoopeston, IL · NPI 1043683014
  Medicare reassignment NPD IL
• Hoopeston Emergency Medicine Specialists, LTD. Emergency Medicine Physician · Hoopeston, IL · NPI 1316965197
  Medicare reassignment NPD IL
• Hoopeston Community Memorial Hospital Critical Access Hospital · Hoopeston, IL · NPI 1366480873
  NPD
• Hoopeston Community Memorial Hospital Rural Health Clinic/Center · Hoopeston, IL · NPI 1578504544
  NPD
• Illinois Phlebology Associates SC Surgery Physician · Orland Park, IL · NPI 1154378040
  NPD (past) PHLEBOLOGY

Medicare participation

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cmartinmd154787@carlehiedirect.net

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 8, 2010.

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278547200000",
    "number": "1083674170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 BUTTERFIELD RD",
            "address_2": "SUITE 220",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605157915",
            "telephone_number": "630-725-2700",
            "fax_number": "847-407-2448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9501 W 144TH PL",
            "address_2": "SUITE 304",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604622561",
            "telephone_number": "708-873-3450",
            "fax_number": "708-873-2791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "CHARLES",
        "middle_name": "FRANKLIN",
        "name_prefix": "Dr.",
        "name_suffix": "I",
        "credential": "MD, FACEP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2010-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "IL",
            "license": "036087693",
            "primary": true
        },
        {
            "code": "202K00000X",
            "taxonomy_group": "",
            "desc": "Phlebology",
            "state": "IL",
            "license": "036087693",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BX",
            "identifier": "0162230X",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orland Park, IL

• Robert K Marshall, PH.D.
• Robert Q Marshall, DDS
• Roseann Martarano, LCSW
• Martie Ryan Lukanich Psy D PC
• Amanda Martin, OTR/L
• Helen Gartner Martin, M.M.
• Jasmine Martin
• Nya Martin, LCSW
• Guillermo Martinez
• Michael Martinez, PTA

All providers in Orland Park, IL · Vascular Surgery Physician in Illinois