Individual ProviderSalvador MartinezPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address1901 W Harrison St, Chicago, IL 60612-3714(773) 869-7488PECOS EnrollmentBased on the most recent information from CMS, provider Salvador Martinez does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1760504732Provider TypeIndividualFull NameMartinez, SalvadorCredentialPAGenderMaleSole ProprietorNoEnumeration Date4/3/2007Last Updated4/27/2021Contact InformationPractice LocationPractice Address1901 W Harrison St, Chicago, IL 60612-3714Phone(773) 869-7488FaxUnlisted FaxMailing LocationMailing Address5255 S Linder Ave, Chicago, IL 60638-1623PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363A00000XPrimaryDescriptionPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersLicense085-000409IllinoisCode363AM0700XDescriptionPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersLicense085-000409Illinois