Organization
JOHN W MATSESHE MD PLLC
Active
Organization
JOHN W MATSESHE MD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN W MATSESHE MD (PRESIDENT)
(847) 899-7165
Entity
Organization
Contact information
Practice address
1445 N HUNT CLUB RD STE 303, GURNEE, IL 60031-2603
(847) 855-3150
Mailing address
438 FARRINGTON DR, LINCOLNSHIRE, IL 60069-2504
(847) 855-3150
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036047991
—
IL
Enumeration date
01/24/2020
Last updated
01/24/2020
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