Dr. Jack Richard Martin
Chiropractor
1601 East Main Street Suite 1b
St Charles
, Illinois 60174
Dr. Jack Richard Martin
Chiropractor
1601 East Main Street Suite 1b
St Charles
, Illinois 60174
(630) 661-1026
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About
Features
Specialties
- Chiropractor
Languages spoken
- English
Location
First Address
- Dr. Jack Richard Martin
- 200 West South Street Suite 5b
- Elburn, IL
- Zip : 60119
- Phone : (630) 661-1026
Second Address
- Dr. Jack Richard Martin
- 1601 East Main Street Suite 1b
- St Charles, IL
- Zip : 60174
- Fax : (630) 377-4958
- Phone : (630) 377-4955
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | IL |
National Provider Identifier
| NPI | 1003914342 |
|---|---|
| Provider Name | Dr. Jack Richard Martin |
| First Address | Elburn, IL 60119 |
| Second Address | St Charles, IL 60174 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 20/09/2006 |
| Last Update Date | 20/11/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 4532187 | BC/BS (01) | IL |
| T37602 | (02) | IL |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.