Provider Demographics
NPI:1437654548
Name:WROBEL, MARTIN MATTHEW (MD)
Entity Type:Individual
Prefix:
First Name:MARTIN
Middle Name:MATTHEW
Last Name:WROBEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 N CUMBERLAND AVE
Mailing Address - Street 2:
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-3215
Mailing Address - Country:US
Mailing Address - Phone:847-825-0300
Mailing Address - Fax:847-825-1825
Practice Address - Street 1:10 N CUMBERLAND AVE
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-3215
Practice Address - Country:US
Practice Address - Phone:847-825-0300
Practice Address - Fax:847-825-1825
Is Sole Proprietor?:No
Enumeration Date:2018-03-29
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125072876207Q00000X
IL036157056207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine