Individual
DR. MATTHEW ERIC DENIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
3412 S ILLINOIS AVE, CARBONDALE, IL 62903-8362
(618) 457-4488
(618) 457-8844
Mailing address
3412 S ILLINOIS AVE, CARBONDALE, IL 62903-8362
(618) 457-4488
(618) 457-8844
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071005515
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0003932032
BLUE CROSS BLUE SHIELD
IL
01
—
045146
HEALTH ALLIANCE
—
01
—
2234448
FIRST HEALTH
—
01
—
229753000
MAGELLAN
—
01
—
429954
HEALTHLINK
—
01
—
7184111
AETNA
—
01
—
UNSPECIFIED
GREAT-WEST HEALTHCARE
—
Enumeration date
08/14/2006
Last updated
03/06/2024
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