Provider Demographics
NPI:1184971699
Name:MARTINEZ, ERIK F (PT, DPT)
Entity type:Individual
Prefix:
First Name:ERIK
Middle Name:F
Last Name:MARTINEZ
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:939 W MADISON ST
Mailing Address - Street 2:STE. 103
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60607-2638
Mailing Address - Country:US
Mailing Address - Phone:312-243-9350
Mailing Address - Fax:773-913-0602
Practice Address - Street 1:939 W MADISON ST
Practice Address - Street 2:STE. 103
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60607-2638
Practice Address - Country:US
Practice Address - Phone:312-243-9350
Practice Address - Fax:773-913-0602
Is Sole Proprietor?:No
Enumeration Date:2012-08-14
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070019295225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist