Provider Demographics
NPI:1497554778
Name:BEASLEY, MARTHA KEMP (RN)
Entity type:Individual
Prefix:MRS
First Name:MARTHA
Middle Name:KEMP
Last Name:BEASLEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:MARTHA
Other - Middle Name:ELIZABETH
Other - Last Name:KEMP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:2027 W HOMER ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60647-4505
Mailing Address - Country:US
Mailing Address - Phone:630-800-8981
Mailing Address - Fax:
Practice Address - Street 1:2233 W DIVISION ST STE 7
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60622-3086
Practice Address - Country:US
Practice Address - Phone:312-770-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-10
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041.453878163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency