Tedjitou Martin PA

NPI 1053454926 - Physician Assistant - 363A00000X

NPI Details
NPI 1053454926
Gender Female
Enumeration Date 02/14/2007
Last Updated 04/28/2009
Entity Type Individual
Active Over 10 years ago
Practice Location
6436 ROOSEVELT RD
307
OAK PARK IL, 60304-2163, US
Phone (708) 655-9606
Fax
Business Location
6436 ROOSEVELT RD
307
OAK PARK IL, 60304-2163, US
Phone (708) 655-9606
Fax
Toxanomy
Taxonomy Code 363A00000X
License State Illinois
License Number 085.002895
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According to our database, Ms. Tedjitou Martin PA NPI is 1053454926, taxonomy code is 363A00000X and license number is 085.002895, license state is located at Illinois. Tedjitou Martin PA physically located at 6436 Roosevelt Rd, Oak Park IL, 60304-2163. NPI Number Tedjitou Martin PA has the Individual type.

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1053454926 NPI number is provided on an as is basis without warranty of any kind. 1053454926 is maintained by the National Plan & Provider Enumeration System. The contents of Tedjitou Martin PA are for informational purposes only.