Lisa Martin, MD MPH

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

36102079 Issued in IL

Practice address

636 Raymond Dr
Suite 205
Naperville, IL 60563-9789

Phone

(630) 717-2300

Fax

(630) 717-9638

NPI assigned

Feb 15, 2006

Last updated

Oct 29, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: lisamartin@pha.allscriptsdirect.net
• Direct secure messaging: lmartin251723@direct.luriechildrens.org

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

• Ann & Robert H. Lurie Children's Hospital of Chicago

  • Children's Hospital
  • Chicago, IL
  • NPI 1235234535
  NPD

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383004800000",
    "number": "1245204122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "636 RAYMOND DR",
            "address_2": "SUITE 205",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605639789",
            "telephone_number": "630-717-2300",
            "fax_number": "630-717-9638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "636 RAYMOND DR",
            "address_2": "SUITE 205",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605639789",
            "telephone_number": "630-717-2300",
            "fax_number": "630-717-9638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "LISA",
        "credential": "MD MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-15",
        "last_updated": "2013-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "36102079",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36102079",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angela Martin, LCPC
• Janice Martin
• Jill Mary Martin, RPH
• John Martin, PH.D.
• Joseph Martin, MD
• Paula G Martin, M.S., CCC-SLP
• Sarah Martin, LPC
• Suzanne K Martin, DT
• Ana Veronica Martinez
• Bridget Martinez

• Pediatrics Physician in Naperville, IL
• Providers in Naperville, IL by specialty
• Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.