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Individual

DR. ALAN HOWARD MATSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M. D.

Contact information

Practice address
77 N AIRLITE ST, ELGIN, IL 60123-4912
(847) 931-5694
Mailing address
1121 LAKE COOK RD STE M, DEERFIELD, IL 60015-5234
(847) 945-4550
(847) 948-8103

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
01067590A
IN
2085R0202X
Diagnostic Radiology Physician
Primary
036-095385
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01067590A
STATE LICENSE
IN
01
036095385
STATE LICENSE #
IL
05
036095385
IL
01
1620188
BC/BS
IL
05
200971740A
IN
Enumeration date
09/27/2006
Last updated
03/07/2023
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