Provider Demographics
NPI:1639592108
Name:MARTINEZ, ALDO (OTR/L)
Entity Type:Individual
Prefix:MR
First Name:ALDO
Middle Name:
Last Name:MARTINEZ
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1635 S 59TH AVE
Mailing Address - Street 2:
Mailing Address - City:CICERO
Mailing Address - State:IL
Mailing Address - Zip Code:60804-1744
Mailing Address - Country:US
Mailing Address - Phone:708-738-0488
Mailing Address - Fax:
Practice Address - Street 1:1010 N HOOKER ST
Practice Address - Street 2:SUITE 3011
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60642-4549
Practice Address - Country:US
Practice Address - Phone:312-943-3600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-03
Last Update Date:2014-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056010419225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist