Individual
JOHN W MATSESHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1445 N HUNT CLUB RD STE 303, GURNEE, IL 60031-2603
(847) 855-3150
Mailing address
438 FARRINGTON DR, LINCOLNSHIRE, IL 60069-2504
(847) 855-3150
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
036047991
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036047991
—
IL
Enumeration date
05/31/2005
Last updated
01/24/2020
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