Provider Demographics
NPI:1164801452
Name:MARTIN, NATALIA CRISTINA (HIS)
Entity Type:Individual
Prefix:
First Name:NATALIA
Middle Name:CRISTINA
Last Name:MARTIN
Suffix:
Gender:F
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1143 S YORK RD
Mailing Address - Street 2:SUITE 15
Mailing Address - City:BENSENVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60106-3342
Mailing Address - Country:US
Mailing Address - Phone:630-833-8382
Mailing Address - Fax:
Practice Address - Street 1:1143 S YORK RD
Practice Address - Street 2:SUITE 15
Practice Address - City:BENSENVILLE
Practice Address - State:IL
Practice Address - Zip Code:60106-3342
Practice Address - Country:US
Practice Address - Phone:630-833-8382
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-20
Last Update Date:2015-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL3204237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist