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Individual
MRS. TERESA MATIAS
Active
Individual
MRS. TERESA MATIAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070-005449
IL
225100000X
Physical Therapist
2515-024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
205086005
MEDICARE
IL
01
—
539320005
MEDICARE
IL
01
—
859400055
MEDICARE
WI
01
—
IL6237007
MEDICARE
IL
01
—
IL6238007
MEDICARE
IL
01
—
IL6697002
MEDICARE
IL
01
—
P01119496
RAIL ROAD MEDICARE
IL
Enumeration date
06/01/2009
Last updated
04/21/2016
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