Provider Demographics
NPI:1295106193
Name:MARTINEZ NOA, JORGE (AARNP-C)
Entity type:Individual
Prefix:
First Name:JORGE
Middle Name:
Last Name:MARTINEZ NOA
Suffix:
Gender:M
Credentials:AARNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 746715
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-6715
Mailing Address - Country:US
Mailing Address - Phone:773-242-2370
Mailing Address - Fax:773-249-1250
Practice Address - Street 1:4327 S ARCHER AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60632-2844
Practice Address - Country:US
Practice Address - Phone:773-242-2370
Practice Address - Fax:773-249-1250
Is Sole Proprietor?:No
Enumeration Date:2015-10-18
Last Update Date:2025-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.033864363LG0600X
FLARNP9334007363LP2300X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care