Individual
CHANDRA A MATTESON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
4946 N RIDGEWAY AVE # 1R, CHICAGO, IL 60625-6006
(415) 845-7642
Mailing address
4946 N RIDGEWAY AVE # 1R, CHICAGO, IL 60625-6006
(415) 845-7642
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209.019807
IL
Other
Enumeration date
08/09/2019
Last updated
08/09/2019
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