Individual provider · Type 1 NPI

Ethan Martinez

Physical Therapy Assistant · Woodridge, IL

NPI number 1104786268 Active

Practice location

6410 Route 53 Ste 300
Woodridge, IL 60517-1361

Call (331) 775-3000 Map

Fax (331) 775-3001

Mailing address

900 Rand Rd Ste 300
Des Plaines, IL 60016-2359

Specialties and licenses

TaxonomyCodeLicense
Physical Therapy Assistant Primary 225200000X160-010567 (IL)

Physical Therapy Assistant: (1)Physical therapist assistants are skilled health care providers who are graduates of a physical therapist assistant associate degree program accredited by an agency recognized by the Secretary of the U.S. Department of Education or Council on Postsecondary Accreditation, who assists the physical therapist in providing physical therapy. The supervising physical therapist is directly responsible for the actions of …

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About NPI 1104786268

Ethan Martinez's National Provider Identifier is 1104786268, issued on Nov 12, 2025. The primary taxonomy on file is Physical Therapy Assistant (225200000X), and the practice location is in Woodridge, IL. The record was last updated on Nov 12, 2025.