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2225 W North Ave Suite I Melrose Park IL 60160-1107 | |
| (708) 345-8255 | |
| (708) 345-0534 |
| Full Name | |
|---|---|
| Speciality | Internal Medicine |
| Location | 2225 W North Ave, Melrose Park, Illinois |
| Authorized Official Name and Position | Anthony Joseph Martino (OWNER) |
| Authorized Official Contact | 7083458255 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
2225 W North Ave Suite I Melrose Park IL 60160-1107 Ph: (708) 345-8255 | 2225 W North Ave Suite I Melrose Park IL 60160-1107 Ph: (708) 345-8255 |
| NPI Number | 1770617862 |
|---|---|
| Provider Enumeration Date | 03/14/2007 |
| Last Update Date | 07/19/2024 |
| Medicare PECOS PAC ID | 6800825274 |
|---|---|
| Medicare Enrollment ID | O20050805000353 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770617862 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 036110934 (Illinois) | Primary |
| Provider Name | Anthony J Martino |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457319337 PECOS PAC ID: 0345279717 Enrollment ID: I20050808000538 |
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