Individual
MATTHEW THOMAS KINGERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1611 W HARRISON ST STE 400, CHICAGO, IL 60612-4861
(877) 632-6637
(708) 409-5179
Mailing address
PO BOX 735263, CHICAGO, IL 60673-5263
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
01100065A
IN
207X00000X
Orthopaedic Surgery Physician
Primary
036.179858
IL
207X00000X
Orthopaedic Surgery Physician
Primary
036179858
IL
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
01100065A
IN
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
036179858
IL
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/20/2020
Last updated
05/08/2026
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