Basic Information
| Provider Information | |||||||||
| NPI: | 1003805136 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HURD | ||||||||
| FirstName: | MARTIN | ||||||||
| MiddleName: | J | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8600 N STATE ROUTE 91 | ||||||||
| Address2: | SUITE 250 | ||||||||
| City: | PEORIA | ||||||||
| State: | IL | ||||||||
| PostalCode: | 616159541 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3096925393 | ||||||||
| FaxNumber: | 3096922583 | ||||||||
| Practice Location | |||||||||
| Address1: | 8600 N STATE ROUTE 91 | ||||||||
| Address2: | SUITE 250 | ||||||||
| City: | PEORIA | ||||||||
| State: | IL | ||||||||
| PostalCode: | 616159541 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3096925393 | ||||||||
| FaxNumber: | 3096922583 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/20/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | IL | X | Allopathic & Osteopathic Physicians | Anesthesiology | 207LP2900X | IL | X | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine | 207Q00000X | IL | X | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.