Individual
MATTHEW SHACHAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
212 W VAN BUREN ST # F6, CHICAGO, IL 60607-3909
(312) 441-0096
(773) 943-7344
Mailing address
212 W VAN BUREN ST # F6, CHICAGO, IL 60607-3909
(312) 441-0096
(773) 943-7344
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019.032689
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/15/2020
Last updated
09/06/2024
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