Individual
MATTHEW DE JONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(888) 584-7888
Mailing address
533 GROVE LN, FOREST PARK, IL 60130-2079
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
125.079458
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
IL
Other
Enumeration date
04/02/2022
Last updated
05/12/2022
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