Provider Demographics
NPI:1649346065
Name:O'DONNELL-MARTINAK, GERALDINE (RPH)
Entity type:Individual
Prefix:MS
First Name:GERALDINE
Middle Name:
Last Name:O'DONNELL-MARTINAK
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:721 TERRACE DR
Mailing Address - Street 2:
Mailing Address - City:ALGONQUIN
Mailing Address - State:IL
Mailing Address - Zip Code:60102-2071
Mailing Address - Country:US
Mailing Address - Phone:847-854-7545
Mailing Address - Fax:
Practice Address - Street 1:580 S ROSELLE RD
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60193-2926
Practice Address - Country:US
Practice Address - Phone:847-895-8646
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist