| Keith R Martin, MD | |
|
1010 Fairway Dr, Freeport, IL 61032-6600 | |
| (815) 599-7750 | |
| Not Available |
| Full Name | Keith R Martin |
|---|---|
| Gender | Male |
| Speciality | Obstetrics/gynecology |
| Experience | 37 Years |
| Location | 1010 Fairway Dr, Freeport, Illinois |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801007190 | NPI | - | NPPES |
| 036084645 | Medicaid | IL | |
| 08932003 | Other | IL | BLUE CROSS BLUE SHIELD OF |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207VH0002X | Obstetrics & Gynecology - Hospice And Palliative Medicine | 036084645 (Illinois) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Fhn Memorial Hospital | Freeport, IL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Freeport Regional Health Care Foundation | 9234041682 | 82 |
| Entity Name | Freeport Regional Health Care Foundation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1457337016 PECOS PAC ID: 9234041682 Enrollment ID: O20031104000182 |
| Entity Name | Cgh Medical Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1902854623 PECOS PAC ID: 6103723267 Enrollment ID: O20031217000054 |
| Entity Name | Freeport Memorial Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1447228788 PECOS PAC ID: 8426958232 Enrollment ID: O20040109000305 |
| Entity Name | Obhg Illinois Sc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1700107216 PECOS PAC ID: 7810179702 Enrollment ID: O20110314001065 |
| Mailing Address | Practice Location Address |
|---|---|
| Keith R Martin, MD 2407 W Galena Ave, Freeport, IL 61032-2903 Ph: (815) 275-3665 | Keith R Martin, MD 1010 Fairway Dr, Freeport, IL 61032-6600 Ph: (815) 599-7750 |
Courtney L Pyant-dan-pullo, MD Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 25 N Harlem Ave, Freeport, IL 61032 Phone: 815-599-7750 Fax: 815-599-7546 | |
Farouk Isawi, MD Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 25 N Harlem Avenue, Freeport, IL 61032 Phone: 815-599-7788 | |
Ruhee Sidhu, MD Obstetrics & Gynecology Medicare: Not Enrolled in Medicare Practice Location: 25 N Harlem Ave, Freeport, IL 61032 Phone: 815-599-7750 Fax: 815-599-7546 |