DR. JACK RICHARD MARTIN (NPI# 1003914342) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003914342 |
| Entity Type | Individual |
| Full Name | DR. JACK RICHARD MARTIN |
| Credential | DC |
| Practice Address |
1601 East Main Street Suite 1b St Charles IL 60174 |
| Mailing Address |
200 West South Street Suite 5b Elburn IL 60119 |
| Practice Telephone | 6303774955 |
| Practice Fax Number | 6303774958 |
| Mailing Telephone | 6306611026 |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2007-11-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | IL | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BC/BS | 4532187 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073707998 | Jack Frederick Martin Sr. | Orthopaedic Surgery | 1220 Aspen Way, Jack F Martin Md, Petoskey, MI 49770 | 2007-09-04 |
| 1700915279 | Jack Kennard Martin | Chiropractor | 203 S Bridge St, Dewitt, MI 48820-8911 | 2007-03-02 |
| 1942206214 | Jack L Martin | Internal Medicine | 18615 Tuscany Stone, Suite 170, San Antonio, TX 78258-3498 | 2005-06-22 |
| 1417592817 | Jack Martin | Counselor | 5675 W Olympic Blvd, Los Angeles, CA 90036-4712 | 2019-11-10 |
| 1255574521 | Jack Robert Martin | Psychologist | 1300 National Dr, Suite 170, Sacramento, CA 95834-1947 | 2009-04-15 |
| 1831309269 | Jack Martin | Counselor | 5934 S Staples St, Suite 210, Corpus Christi, TX 78413-3842 | 2007-05-23 |
| 1790879765 | Jack W. Martin | Dentist | 1515 Holcombe Blvd, Houston, TX 77030-4009 | 2006-10-03 |
| 1932159878 | Jack T. Martin | Radiology | 4518 Union Deposit Rd, Harrisburg, PA 17111-2910 | 2006-05-11 |
| Street Address |
1601 EAST MAIN STREET SUITE 1B |
| City | ST CHARLES |
| State | IL |
| Zip Code | 60174 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306474192 | Halinas Residential Home Care | Registered Nurse | 825 North Fifth Avenue, St. Charles, IL 60174 | 2020-03-29 |
| 1205354503 | Connor Lavallie | Chiropractor | 240 W River Dr, St Charles, IL 60174 | 2017-09-07 |
| 1427579952 | Melanie Elizabeth Long | Counselor | 5n147 Oak Leaf Ct, St Charles, IL 60174 | 2017-07-06 |
| 1255860656 | Hannah Elizabeth Gambrel | Counselor | 12 South 7th Avenue, St. Charles, IL 60174 | 2017-06-08 |
| 1275981490 | Anju Patel | Pharmacist | 2038 Praire St, St. Charles, IL 60174 | 2016-05-27 |
| 1316328529 | Allison Jensen | Dentist | 11 S. 2nd Ave #11, St. Charles, IL 60174 | 2015-06-12 |
| 1225466576 | Chelsea Wright | Social Worker | 522 W Main St Unit 2d, St Charles, IL 60174 | 2013-10-24 |
| 1114261427 | Bryan R. Cichon Dds PC | Dentist | 700 S. Randall Rd., Suite #1, St. Charles, IL 60174 | 2012-11-27 |
| 1124372289 | Stacey Lynn Conner | Developmental Therapist | 910 Manley Rd, St. Charles, IL 60174 | 2012-10-28 |
| 1093070567 | St. Charles Service Corporation | Physical Therapist | 1615 W. Main Street, St. Charles, IL 60174 | 2012-07-10 |
| Find all providers in zip 60174 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639700776 | Longevity Health and Fitness, Inc. | Chiropractor | 1150 N 5th Ave Ste B2, St Charles, IL 60174-1277 | 2020-01-28 |
| 1659901296 | Alysha Alonzo | Chiropractor | 451 Dunham Rd Ste 700, St Charles, IL 60174-1444 | 2020-01-23 |
| 1174174122 | Quast Dc Ltd | Chiropractor | 451 Dunham Rd Ste G, St Charles, IL 60174-1431 | 2019-09-21 |
| 1497228746 | Runyan Chiropractic LLC | Chiropractor | 1607 E Main St Ste A, St Charles, IL 60174-2390 | 2019-01-09 |
| 1639644115 | C&s Health LLC | Chiropractor | 1450 W Main St Ste G, St Charles, IL 60174-1679 | 2018-10-10 |
| 1710487756 | Kimbra Nicole Runyan | Chiropractor | 1607 E Main St Ste 2a, St Charles, IL 60174-2390 | 2018-02-16 |
| 1609397983 | Tmj and Sleep Therapy Centre of Chicago LLC | Chiropractor | 700 E Main St Ste A, St Charles, IL 60174-2200 | 2017-06-27 |
| 1215373857 | Phillip Andrew Gamble | Chiropractor | 409 Illinois Ave Unit 1c, St Charles, IL 60174-2966 | 2013-05-21 |
| 1356686695 | Colleen Marie Horn | Chiropractor | 1750 E Main St Ste 140, St Charles, IL 60174-2363 | 2012-11-27 |
| 1730449315 | Michael Pica P.C. | Chiropractor | 4n701 School Rd Ste A, St Charles, IL 60175-6508 | 2012-05-17 |
| Find all providers in ST CHARLES | ||||
| City | ST CHARLES |
| Zip Code | 60174 |
Please comment or provide details below to improve the information on DR. JACK RICHARD MARTIN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.