1851412415 NPI number — MARTA JOSEFINA ARROYO

Table of content: MARTA JOSEFINA ARROYO (NPI 1851412415)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851412415 NPI number — MARTA JOSEFINA ARROYO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ARROYO
Provider First Name:
MARTA
Provider Middle Name:
JOSEFINA
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ARROYO-ROSS
Provider Other First Name:
MARTA
Provider Other Middle Name:
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1851412415
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3600 WINTERGREEN TER
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ALGONQUIN
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60102-6367
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
847-854-0439
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1555 BARRINGTON RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOFFMAN ESTATES
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60194-1019
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
847-882-2600
Provider Business Practice Location Address Fax Number:
847-882-2637
Provider Enumeration Date:
04/02/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2080A0000X , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)