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Individual
MATTHEW TODD ANTCZAK
Active
Individual
MATTHEW TODD ANTCZAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038-007424
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05606277
BLUE CROSS BLUE SHIELD
IL
Enumeration date
02/19/2007
Last updated
04/29/2008
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