Provider Demographics
NPI:1710937040
Name:MARTIN, HILDA KLEIN (MD)
Entity Type:Individual
Prefix:MRS
First Name:HILDA
Middle Name:KLEIN
Last Name:MARTIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2824 W CATALPA AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60625-3212
Mailing Address - Country:US
Mailing Address - Phone:773-561-1070
Mailing Address - Fax:773-561-1109
Practice Address - Street 1:2824 W CATALPA AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60625-3212
Practice Address - Country:US
Practice Address - Phone:773-561-1070
Practice Address - Fax:773-561-1109
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL781440Medicare ID - Type Unspecified
ILD16595Medicare UPIN