Active NPI
Lillian Martinez
- Counselor
- Melrose Park, IL
National Provider Identifier
1982192985
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- M63552093863
- Practice address
- 4419 W North Ave
Melrose Park, IL 60160-1021 - Phone
- (773) 777-7112
- NPI assigned
- Apr 25, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | M63552093863 | IL | Primary |
Addresses
Primary practice location
4419 W North Ave
Melrose Park, IL 60160-1021
Mailing address
4419 W North Ave
Melrose Park, IL 60160-1021
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M63552093863 | IL | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Youth Outreach Services | Past | Accepting new patients | |
| Youth Outreach Services | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Melrose Park, IL
- NPI 1568916476
-
- Substance Use Disorder Rehabilitation Clinic/Center
- Melrose Park, IL
- NPI 1811227341
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1524614400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1524614400000",
"number": "1982192985",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4419 W NORTH AVE",
"city": "MELROSE PARK",
"state": "IL",
"postal_code": "601601021"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4419 W NORTH AVE",
"city": "MELROSE PARK",
"state": "IL",
"postal_code": "601601021",
"telephone_number": "773-777-7112"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTINEZ",
"first_name": "LILLIAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-04-25",
"last_updated": "2018-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "IL",
"license": "M63552093863",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Melrose Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.