Provider Demographics
NPI:1437955796
Name:MARTINEZ, MICHAEL A (HSW)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:A
Last Name:MARTINEZ
Suffix:
Gender:M
Credentials:HSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 W MECHANIC ST
Mailing Address - Street 2:
Mailing Address - City:ROCKTON
Mailing Address - State:IL
Mailing Address - Zip Code:61072-2420
Mailing Address - Country:US
Mailing Address - Phone:608-622-4123
Mailing Address - Fax:
Practice Address - Street 1:107 W MECHANIC ST
Practice Address - Street 2:
Practice Address - City:ROCKTON
Practice Address - State:IL
Practice Address - Zip Code:61072-2420
Practice Address - Country:US
Practice Address - Phone:608-888-3704
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-19
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant