Provider Demographics
NPI:1376346932
Name:MARTINO, SAMANTHA (MS, ACSM-CEP)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:MARTINO
Suffix:
Gender:F
Credentials:MS, ACSM-CEP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1443 BANNOCK CT
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:IL
Mailing Address - Zip Code:60103-2978
Mailing Address - Country:US
Mailing Address - Phone:630-877-7528
Mailing Address - Fax:
Practice Address - Street 1:900 W CENTRAL RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-2373
Practice Address - Country:US
Practice Address - Phone:847-618-7913
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-29
Last Update Date:2025-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1076434224Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Y00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersClinical Exercise Physiologist