Individual
MR. MARK TIMOTHY MATOVU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1845 GRANDSTAND PL, ELGIN, IL 60123-6603
(815) 219-6584
Mailing address
1417 DIXIE CT APT 201, SCHAUMBURG, IL 60193-5432
(815) 212-5867
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
12/09/2022
Last updated
12/09/2022
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