Organization
MARSHALL I MATZ & DAVID M SHENKER MDSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARSHALL I MATZ M.D. (PRESIDENT)
(312) 332-2226
Entity
Organization
Contact information
Practice address
1431 N WESTERN AVE, SUITE 306, CHICAGO, IL 60622-1797
(312) 332-2226
(773) 276-1197
Mailing address
1431 N WESTERN AVE, SUITE 306, CHICAGO, IL 60622-1797
(312) 332-2226
(773) 276-1197
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
036039812
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01615166
BLUE SHIELD
IL
Enumeration date
01/25/2007
Last updated
06/20/2008
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