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Individual
MR. MATTHEW HART
Active
Individual
MR. MATTHEW HART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTRL, ATP, CDRS
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
113326
HEALTHLINK PROV ID
—
01
—
203
BLUE CROSS PROV ID
IL
01
—
4117
HAMP PROVIDER ID
IL
01
—
7216
PERSONALCARE PROV ID
—
Enumeration date
03/29/2007
Last updated
07/08/2007
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