Ricardo Martinez, MD, PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036087720 Issued in IL

Legal business name

RICARDO MARTINEZ, MD, PC

Practice address

1201 W Army Trail Blvd
Addison, IL 60101-3152

Phone

(630) 458-9200

Fax

(630) 458-8460

NPI assigned

Nov 5, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Ricardo Martinez, M.D.

Title

President

Phone

(630) 458-9200

Specialties & licenses 2

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1131148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403654400000",
    "number": "1124009360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 W ARMY TRAIL BLVD",
            "city": "ADDISON",
            "state": "IL",
            "postal_code": "601013152",
            "telephone_number": "630-458-9200",
            "fax_number": "630-458-8460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 W ARMY TRAIL BLVD",
            "city": "ADDISON",
            "state": "IL",
            "postal_code": "601013152",
            "telephone_number": "630-458-9200",
            "fax_number": "630-458-8460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICARDO MARTINEZ, MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-05",
        "last_updated": "2014-06-25",
        "status": "A",
        "authorized_official_last_name": "MARTINEZ",
        "authorized_official_first_name": "RICARDO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-458-9200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036087720",
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "IL",
            "license": "036087720",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAR RR",
            "identifier": "08143606",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036087720",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Addison, IL
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2014; 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.