Individual
MARY MATUSZAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CMMP
Contact information
Practice address
6039 W 55TH ST, CHICAGO, IL 60638-2644
(773) 424-0032
(773) 424-0032
Mailing address
6039 W 55TH ST, CHICAGO, IL 60638-2644
(708) 362-0447
(773) 424-0032
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
227.016717
IL
Other
Enumeration date
05/28/2014
Last updated
05/28/2014
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