Provider Demographics
NPI:1528417136
Name:MARTEY, PAMELA MARTEYKUOR (MD)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:MARTEYKUOR
Last Name:MARTEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:PAMELA
Other - Middle Name:MARTEYKUOR
Other - Last Name:MARTEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1969 W OGDEN AVE
Mailing Address - Street 2:DEPARTMENT OF PEDIATRICS JOHN H STROGER JR HOSPITAL OF
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-3765
Mailing Address - Country:US
Mailing Address - Phone:312-864-6000
Mailing Address - Fax:
Practice Address - Street 1:1900 WEST POLK STREET
Practice Address - Street 2:RM 1134 ADMINISTRATION BUILDING
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612
Practice Address - Country:US
Practice Address - Phone:312-864-9717
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-06
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125068867208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics