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Individual
SUSAN CHACKO MATTHEW
Active
Individual
SUSAN CHACKO MATTHEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ND APN FNP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
41285306
IL
363L00000X
Nurse Practitioner
209002419
IL
363LF0000X
Family Nurse Practitioner
Primary
209002419
IL
363LP2300X
Primary Care Nurse Practitioner
209002419
IL
Other
Enumeration date
05/04/2007
Last updated
02/24/2026
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