| Doctor Name: | DR. MARTIN EDWARD LEMON |
| NPI Number: | 1063650141 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PH.D. |
| License Number: | 071004794 |
| Business Practice Address: | 28379 Davis Pkwy Suite 801 Warrenville, IL - 605553032 |
| Business Phone Number: | 6303939800 |
| Business Fax Number: | 6393930499 |
| Mailing Address: | 28379 Davis Pkwy, Suite 801 WARRENVILLE |
| State: | IL |
| Postal Code: | 605553032 |
| Phone Number: | 6303939800 |
| Fax Number: | 6393930499 |
| NPI Enumeration Date: | 01/28/2009 |
| NPI Last Update Date: | 01/28/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 071004794 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |