Individual
STEPHEN S MATTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2200 JACOBSSEN DR, NORMAL, IL 61761-5516
(309) 451-1123
(309) 451-1212
Mailing address
2200 JACOBSSEN DR, NORMAL, IL 61761-5516
(309) 451-1123
(309) 451-1212
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
36078825
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0360788251
—
IL
05
—
201622626001
—
IL
Enumeration date
09/22/2006
Last updated
08/14/2008
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