Sergio Martinez, RN

Individual provider Active NPI Registered Nurse · Davis Junction, IL

NPI 1740928795 · NPPES record last updated May 20, 2022

Key facts

NPI
1740928795
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
041504790 (IL)
Practice address
12521 E High Rd
Davis Junction, IL 61020-9717
Phone
(815) 904-2332
NPI assigned
May 20, 2022
Sex
Male
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
041504790ILMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 041504790 IL Yes

Addresses

Primary practice location

12521 E High Rd
Davis Junction, IL 61020-9717

Mailing address

12521 E High Rd
Davis Junction, IL 61020-9717
Phone (815) 904-2332

Electronic endpoints

TypeEndpointUseAffiliation
CONNECT URL endpoint

Other providers in Davis Junction, IL

All providers in Davis Junction, IL · Registered Nurse in Illinois

Sources for this page

Verify at the official NPI Registry.