Individual
MATTHEW DAVID RATHBUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
2955 W 95TH ST, EVERGREEN PARK, IL 60805-2409
(331) 814-2186
Mailing address
15027 W KESWICK PL, LOCKPORT, IL 60441-6251
(630) 390-4567
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
209021678
IL
363LP2300X
Primary Care Nurse Practitioner
Primary
209021678
IL
Other
Enumeration date
09/11/2020
Last updated
09/11/2020
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