Provider Demographics
NPI:1184814501
Name:JONES-MARTINEZ, NICOLE C (MD)
Entity Type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:C
Last Name:JONES-MARTINEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:C
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:999 OAKMONT PLAZA DR
Mailing Address - Street 2:STE 100
Mailing Address - City:WESTMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60559-5563
Mailing Address - Country:US
Mailing Address - Phone:630-850-2120
Mailing Address - Fax:
Practice Address - Street 1:999 OAKMONT PLAZA DR
Practice Address - Street 2:STE 100
Practice Address - City:WESTMONT
Practice Address - State:IL
Practice Address - Zip Code:60559-5563
Practice Address - Country:US
Practice Address - Phone:630-850-2120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-01
Last Update Date:2014-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-1250652084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL390200000XMedicaid