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Individual

MATTHEW ANTALEK JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2650 RIDGE AVE, EVANSTON, IL 60201-1700
(847) 570-2475
(847) 570-2942
Mailing address
2650 RIDGE AVE, EVANSTON, IL 60201-1700
(847) 570-2475
(847) 570-2942

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
036176567
IL
2085R0204X
Vascular & Interventional Radiology Physician
Primary
036176567
IL
208600000X
Surgery Physician
036176567
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
036176567
STATE LICENSE
IL
Enumeration date
03/03/2015
Last updated
08/14/2025
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