Martinez Vein Center

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

036099034 Issued in IL

Legal business name

MARTINEZ VEIN CENTER

Practice address

114 Bartlett PLZ
Bartlett, IL 60103-4234

Phone

(630) 483-0665

Fax

(630) 483-0526

NPI assigned

Dec 2, 2010

Organization subpart

No

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

Authorized official

Name

Jorge E. Martinez, M.D.

Title

Owner

Phone

(630) 483-0665

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Martinez Vein Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Martinez Vein Center

  • Family Medicine Physician
  • Bartlett, IL
  • NPI 1386978286
  NPD tax ID

Locations

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

{
    "created_epoch": "1291248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291248000000",
    "number": "1871895474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8268",
            "city": "BARTLETT",
            "state": "IL",
            "postal_code": "601038268",
            "telephone_number": "630-483-0665",
            "fax_number": "630-483-0526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 BARTLETT PLZ",
            "city": "BARTLETT",
            "state": "IL",
            "postal_code": "601034234",
            "telephone_number": "630-483-0665",
            "fax_number": "630-483-0526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARTINEZ VEIN CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-02",
        "last_updated": "2010-12-02",
        "status": "A",
        "authorized_official_last_name": "MARTINEZ",
        "authorized_official_first_name": "JORGE",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-483-0665",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "IL",
            "license": "036099034",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36099034",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Candace Mallory, COTA/L
• Nicole Maronde, LCSW
• Gildo Apa Marte II, P.T.
• Lauryn Martin
• Martinez Vein Center
• Jorge E Martinez, MD
• Maryville Academy
• Maryville Academy
• Maryville Academy
• Maryville Academy

• Preferred Provider Organization in Bartlett, IL
• Providers in Bartlett, IL by specialty
• Preferred Provider Organization in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2010; 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.