Provider Demographics
NPI:1235259656
Name:SANUKA MEDICAL CENTER SC
Entity Type:Organization
Organization Name:SANUKA MEDICAL CENTER SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:EDUARDO
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:630-483-0665
Mailing Address - Street 1:114 BARTLETT PLZ
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:IL
Mailing Address - Zip Code:60103-4234
Mailing Address - Country:US
Mailing Address - Phone:630-483-0665
Mailing Address - Fax:630-483-0526
Practice Address - Street 1:114 BARTLETT PLZ
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:IL
Practice Address - Zip Code:60103-4234
Practice Address - Country:US
Practice Address - Phone:630-483-0665
Practice Address - Fax:630-483-0526
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-30
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty