Provider Demographics
NPI:1043200165
Name:BOYER, MARTIN J (DO)
Entity Type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:J
Last Name:BOYER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:700 COMMERCE DR
Mailing Address - Street 2:SUITE 500
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-1546
Mailing Address - Country:US
Mailing Address - Phone:847-698-0600
Mailing Address - Fax:847-698-0600
Practice Address - Street 1:800 BIESTERFIELD RD
Practice Address - Street 2:SUITE 110
Practice Address - City:ELK GROVE VLG
Practice Address - State:IL
Practice Address - Zip Code:60007-3361
Practice Address - Country:US
Practice Address - Phone:847-981-5760
Practice Address - Fax:847-956-5138
Is Sole Proprietor?:No
Enumeration Date:2005-10-28
Last Update Date:2021-12-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL0360833342085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL558620004OtherMEDICARE PTAN
IL920005272OtherRAILROAD MEDICARE
IL920005581OtherRAILROAD MEDICARE
IL778401002OtherMEDICARE PTAN
IL920005573OtherRAILROAD MEDICARE
IL036083334Medicaid
IL920002862OtherRAILROAD MEDICARE
IL920005581OtherRAILROAD MEDICARE
F36725Medicare UPIN