Provider Demographics
NPI:1013981463
Name:LINDENBERGER, MARTIN (MD)
Entity Type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:
Last Name:LINDENBERGER
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 1:3719 DOWNERS DR
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-1329
Mailing Address - Country:US
Mailing Address - Phone:773-776-3422
Mailing Address - Fax:773-776-3457
Practice Address - Street 1:3124 W 59TH ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60629-2504
Practice Address - Country:US
Practice Address - Phone:773-776-3422
Practice Address - Fax:773-776-3457
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-14
Last Update Date:2010-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-057431207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL205458Medicare ID - Type Unspecified
ILL36591Medicare UPIN