Individual
MR. MATTHEW DARRELL SPRAYBERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
259 E ERIE ST, CHICAGO, IL 60611
(312) 695-0665
Mailing address
680 N. LAKE SHORE DRIVE, CHICAGO, IL 60611-2987
(312) 695-6868
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041.478201
IL
163W00000X
Registered Nurse
223941
NC
367500000X
Certified Registered Nurse Anesthetist
Primary
209.019297
IL
367500000X
Certified Registered Nurse Anesthetist
223941
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8053981
—
NC
05
—
NAN998
—
SC
Enumeration date
12/09/2010
Last updated
05/22/2019
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