Provider Demographics
NPI:1639859788
Name:MARTINEZ, ANN MARIE
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:MARIE
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 HARDWICK CT
Mailing Address - Street 2:
Mailing Address - City:SUGAR GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60554-4113
Mailing Address - Country:US
Mailing Address - Phone:630-549-9800
Mailing Address - Fax:
Practice Address - Street 1:120 GALE ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60506-5084
Practice Address - Country:US
Practice Address - Phone:630-897-1003
Practice Address - Fax:630-897-1042
Is Sole Proprietor?:No
Enumeration Date:2023-07-24
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No104100000XBehavioral Health & Social Service ProvidersSocial Worker