Individual
DR. MATTHEW L KAMIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3800 W 203RD ST STE 204, OLYMPIA FIELDS, IL 60461-1185
(708) 679-2670
(708) 503-3260
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
02004383A
IN
207RC0000X
Cardiovascular Disease Physician
Primary
036-101235
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036101235
—
IL
01
—
1124399605
BCBS GROUP NUMBER
IL
05
—
201288220
—
IN
Enumeration date
08/26/2005
Last updated
01/08/2020
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