Provider Demographics
NPI:1003064585
Name:MARTINEZ, RUBEN ARTURO (COTA/L)
Entity Type:Individual
Prefix:MR
First Name:RUBEN
Middle Name:ARTURO
Last Name:MARTINEZ
Suffix:
Gender:M
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7667 N SHERIDAN RD APT 2D
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60626-1316
Mailing Address - Country:US
Mailing Address - Phone:773-396-8800
Mailing Address - Fax:
Practice Address - Street 1:7667 N SHERIDAN RD APT 2D
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60626-1316
Practice Address - Country:US
Practice Address - Phone:773-396-8800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-08
Last Update Date:2008-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL057002205224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant