Provider Demographics
NPI:1730195652
Name:WOOD, MARTINIQUE (AUD)
Entity type:Individual
Prefix:DR
First Name:MARTINIQUE
Middle Name:
Last Name:WOOD
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:172 E SCHILLER ST
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-2816
Mailing Address - Country:US
Mailing Address - Phone:630-993-5676
Mailing Address - Fax:630-758-9940
Practice Address - Street 1:1200 S YORK RD
Practice Address - Street 2:SUITE 2000
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126-5626
Practice Address - Country:US
Practice Address - Phone:630-993-5676
Practice Address - Fax:630-758-9940
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist