Individual
MATTHEW ROOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
700 W JEFFERSON ST, SHOREWOOD, IL 60404-7608
(815) 514-2040
(815) 741-2860
Mailing address
1860 PAYSPHERE CIR, CHICAGO, IL 60674-0018
(630) 469-9200
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036.157948
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/14/2018
Last updated
09/29/2021
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