Individual
PAUL MATTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4309 W MEDICAL CENTER DR STE A201, MCHENRY, IL 60050-8411
(815) 385-0084
Mailing address
16928 BOULDER WAY, MACOMB, MI 48042-3516
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
041437972
IL
367500000X
Certified Registered Nurse Anesthetist
041437972
IL
367500000X
Certified Registered Nurse Anesthetist
Primary
209025407
IL
Other
Enumeration date
04/18/2022
Last updated
03/21/2024
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