Provider Demographics
NPI:1801937305
Name:MARTIN HEALTH & REHABILITATION, S.C.
Entity type:Organization
Organization Name:MARTIN HEALTH & REHABILITATION, S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT,SOLE OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:708-334-4800
Mailing Address - Street 1:8210 SCHOOL ST
Mailing Address - Street 2:
Mailing Address - City:LA GRANGE
Mailing Address - State:IL
Mailing Address - Zip Code:60525-5227
Mailing Address - Country:US
Mailing Address - Phone:708-334-4800
Mailing Address - Fax:708-839-1323
Practice Address - Street 1:161 MARKET ST
Practice Address - Street 2:
Practice Address - City:WILLOW SPRINGS
Practice Address - State:IL
Practice Address - Zip Code:60480-1613
Practice Address - Country:US
Practice Address - Phone:708-334-4800
Practice Address - Fax:708-839-1323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty