| Doctor Name: | CONSTANCE M. MARTIN |
| NPI Number: | 1134279664 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PH.D. |
| License Number: | 071-005433 |
| Business Practice Address: | 7101 N Cicero Ave Suite 203 Lincolnwood, IL - 607122112 |
| Business Phone Number: | 3124589086 |
| Business Fax Number: | 8479834783 |
| Mailing Address: | 7101 N Cicero Ave, Suite 203 LINCOLNWOOD |
| State: | IL |
| Postal Code: | 607122112 |
| Phone Number: | 3124589086 |
| Fax Number: | 8479834783 |
| NPI Enumeration Date: | 01/10/2007 |
| NPI Last Update Date: | 01/06/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 071-005433 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |