KEITH R MARTIN (NPI# 1801007190) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801007190 |
| Entity Type | Individual |
| Full Name | KEITH R MARTIN |
| Credential | MD |
| Practice Address |
3103 W Kunkle Blvd Freeport IL 61032-6922 |
| Practice Telephone | 8152330999 |
| Practice Fax Number | 8152337255 |
| Mailing Telephone | 8152330999 |
| Mailing Fax Number | 8152337255 |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207VH0002X |
Obstetrics & Gynecology Specialization: Hospice and Palliative Medicine |
IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BLUE CROSS BLUE SHIELD OF | 08932003 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952914269 | Keith A Martin | Technician | 1675 Meadow Bridge Rd, Meadow Bridge, WV 25976-9658 | 2020-08-26 |
| 1811542020 | Keith Andrew Martin | Physical Therapy Assistant | 8551 Wakefield Dr, Palm Beach Gardens, FL 33410-6363 | 2019-08-05 |
| 1518352590 | Keith Martin | Pediatrics | 3430 Burnet Avenue, Ml 5026, Cincinnati, OH 45229 | 2015-04-06 |
| 1922376771 | Keith Eric Martin | Social Worker | 2491 Purdue Ave, 213, Los Angeles, CA 90064-3046 | 2011-12-08 |
| 1285803270 | Keith Alan Martin | Physical Therapist | 6640 Parkdale Pl Ste T, Indianapolis, IN 46254-5619 | 2008-02-25 |
| 1356302657 | Keith Albert Martin | Dentist | 9100 E 29th St N, Wichita, KS 67226-2177 | 2006-03-28 |
| 1770569923 | Keith Blaine Martin | Chiropractor | 309 2nd St Se Ste 101, Auburn, WA 98002-5543 | 2005-12-20 |
| 1013211663 | Keith Martin | Social Worker | 56 Bay St, Staten Island, NY 10301-2563 | 2010-12-22 |
| 1003027046 | Keith Stanley Martin | Social Worker | 9300 Valley Childrens Pl, Madera, CA 93638-8761 | 2007-05-24 |
| 1649280546 | Keith L Martin | Specialist | 16671 Yorba Linda Blvd, Suite 200, Yorba Linda, CA 92886-2025 | 2006-08-09 |
| Street Address |
3103 W KUNKLE BLVD |
| City | FREEPORT |
| State | IL |
| Zip Code | 61032-6922 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093713364 | Highland Women's Care | Nurse Practitioner | 3103 W Kunkle Blvd, Freeport, IL 61032-6922 | 2005-07-12 |
| 1649471434 | Sara E Smith | Nurse Practitioner | 3103 W Kunkle Blvd, Freeport, IL 61032-6922 | 2007-05-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013517713 | Saad Awan | Pharmacist | 2545 Illinois 26 S, Freeport, IL 61032 | 2020-10-30 |
| 1891354460 | Freeport Chiropractic LLC | Chiropractor | 2 W Stephenson St, Freeport, IL 61032 | 2019-06-07 |
| 1487168373 | Lindsey Rae Harris-baker | Speech-Language Pathologist | 1802 W Laurel St, Freeport, IL 61032 | 2017-11-30 |
| 1861871246 | Pearl Pavilion LLC | Skilled Nursing Facility | 910 Kiwanis Drive, Freeport, IL 61032 | 2015-05-19 |
| 1245584598 | Mary E Brown | Massage Therapist | 815 W. Pleasant Street, Freeport, IL 61032 | 2012-11-07 |
| 1700135803 | April Braband | Specialist | 421 Exchange, Freeport, IL 61032 | 2012-09-05 |
| 1518198662 | Quad City Prosthetic Inc | Prosthetic/Orthotic Supplier | 1013 W Loras Dr, Suite A, Freeport, IL 61032 | 2009-08-06 |
| 1447486501 | Gary Alan Besley | Dentist | 1450 S. West Ave., Freeport, IL 61032 | 2009-06-03 |
| 1023244290 | Allies In Health Sc | Chiropractor | 418 W Meadows Dr., Freeport, IL 61032 | 2009-06-02 |
| 1912146614 | Kayla Nicole Rodebaugh | Specialist/Technologist | 1010 Fairway Drive, Freeport, IL 61032 | 2009-02-19 |
| Find all providers in zip 61032 | ||||
| Taxonomy Code | 207VH0002X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| Specialization | Hospice and Palliative Medicine |
| An obstetrician/gynecologist with special knowledge and skills to prevent and relieve the suffering experienced by patients with life-limiting illnesses. This specialist works with an interdisciplinary hospice or palliative care team to maximize quality of life while addressing physical, psychological, social and spiritual needs of both patient and family throughout the course of the disease, through the dying process, and beyond for the family. This specialist has expertise in the assessment of patients with advanced disease; the relief of distressing symptoms; the coordination of interdisciplinary patient and family-centered care in diverse venues; the use of specialized care systems including hospice; the management of the imminently dying patient; and legal and ethical decision making in end-of-life care. |
| Notes: Source: American Academy of Hospice and Palliative Medicine, www.aahpm.org [1/1/2007: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457563272 | Ob-gyne Associates of Libertyville, Sc | Obstetrics & Gynecology | 801 S Milwaukee Avenue, Ste 100, Libertyville, IL 60048 | 2007-05-04 |
| 1942424486 | Kannan Sundar | Obstetrics & Gynecology | 4400 W 95th St Ste 207, Oak Lawn, IL 60453-2658 | 2007-04-13 |
| 1255453494 | Chams Women's Health Care, Sc | Obstetrics & Gynecology | 4200 W Peterson Ave Ste 101, Chicago, IL 60646-6052 | 2007-04-06 |
| 1689627226 | Samuel R. Katz | Obstetrics & Gynecology | 2050 Claire Ct, Glenview, IL 60025-7635 | 2006-05-17 |
| 1679775423 | John G. Bush, Do Ltd | Obstetrics & Gynecology | 222 Colorado Ave., Frankfort, IL 60423-1334 | 2007-06-04 |
| 1659586279 | Carl P Mattioda Md and Chaoming Chen Mdsc | Obstetrics & Gynecology | 104 W 6th St, Streator, IL 61364-2899 | 2007-05-14 |
| 1457565426 | Northwestern Perinatal Associates, S.c. | Obstetrics & Gynecology | 680 N Lake Shore Drive, Suite 1428, Chicago, IL 60611-8700 | 2007-05-09 |
| 1316151558 | Friberg Medical Associates | Obstetrics & Gynecology | 845 N Michigan Ave, Suite 935 E, Chicago, IL 60611-2252 | 2007-05-09 |
| 1710100862 | Richard George Moutvic | Obstetrics & Gynecology | 233 W Joe Orr Rd, Chicago Heights, IL 60411-1744 | 2007-04-10 |
| 1831312909 | Vida M Bartasius | Obstetrics & Gynecology | 233 W Joe Orr Rd, Chicago Heights, IL 60411-1744 | 2007-04-10 |
| Find all providers with the same taxonomy | ||||
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| 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.