Individual provider Active NPI

Alma Mia Rosal Martija, MD

  • General Practice Physician
  • Joliet, IL
National Provider Identifier
1093094690
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
036.103214 Issued in IL
Practice address
1301 Copperfield Ave
Suite 206
Joliet, IL 60432-2054
Phone
(815) 726-2368
Fax
(815) 774-4799
NPI assigned
Aug 12, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 036.103214 IL Primary

Addresses

Primary practice location

1301 Copperfield Ave
Suite 206
Joliet, IL 60432-2054

Mailing address

1301 Copperfield Ave
Suite 206
Joliet, IL 60432-2054
Phone (815) 726-2368

Other identifiers 1

IdentifierTypeStateIssuer
036-103214OtherILDEPT OF FINANCIAL AND PROFESSIONAL REGULATION

Other names 1

  • Mrs. Alma Mia Martija Wulff Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036.103214ILMDGeneral Practice Physician

Interoperability endpoints

  • Direct secure messaging: alma.mia.martija.1@14940.direct.athenahealth.com

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1313107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1093094690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 COPPERFIELD AVE",
            "address_2": "SUITE 206",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604322054",
            "telephone_number": "815-726-2368",
            "fax_number": "815-774-4799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 COPPERFIELD AVE",
            "address_2": "SUITE 206",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604322054",
            "telephone_number": "815-726-2368",
            "fax_number": "815-774-4799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIJA",
        "first_name": "ALMA MIA",
        "middle_name": "ROSAL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-12",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "IL",
            "license": "036.103214",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF FINANCIAL AND PROFESSIONAL REGULATION",
            "identifier": "036-103214",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALMA MIA",
            "last_name": "WULFF",
            "middle_name": "MARTIJA",
            "prefix": "MRS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Joliet, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.