Individual
TOMY MATHEW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
111 E WASHINGTON ST, BENSENVILLE, IL 60106-2674
(630) 766-5800
Mailing address
1204 W PALM DR, MT PROSPECT, IL 60056-4129
(773) 349-7154
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160.005617
IL
Other
Enumeration date
10/10/2012
Last updated
10/10/2012
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