John Edward Martin, M.D.

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

36-040469 Issued in IL

Practice address

4318 Grand Ave
Western Springs, IL 60558-1436

Phone

(708) 508-2038

Fax

(708) 246-4457

NPI assigned

Jul 15, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

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

{
    "created_epoch": "1121385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184803200000",
    "number": "1295734952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4318 GRAND AVE",
            "city": "WESTERN SPRINGS",
            "state": "IL",
            "postal_code": "605581436",
            "telephone_number": "708-508-2038",
            "fax_number": "708-246-4457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4318 GRAND AVE",
            "city": "WESTERN SPRINGS",
            "state": "IL",
            "postal_code": "605581436",
            "telephone_number": "708-508-2038",
            "fax_number": "708-246-4457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "JOHN",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-15",
        "last_updated": "2007-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "IL",
            "license": "36-040469",
            "primary": true
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MI",
            "license": "4301046776",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Renee Lyons
• Alexa Maisenbach, PHARMD
• Edward T Marcoski Jr., MD
• Marjorie Miller, D.D.S., P.C.
• Theresa Marousek
• Rebekka Martin, B.A.
• Sarah Moore Martin
• Vivian Masso-Corral
• Karla Mata
• Craig James Mawdsley, DPT, COMT, FAAOMPT

• Pulmonary Disease Physician in Western Springs, IL
• Providers in Western Springs, IL by specialty
• Pulmonary Disease Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2007; 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.