Individual
MR. RICHARD ALEXANDER MATIASZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
251 EAST HURON STREET, CHICAGO, IL 60611
(312) 695-0070
(312) 695-0063
Mailing address
676 N ST CLAIR STREET, SUITE 600, CHICAGO, IL 60611
(312) 695-0700
(312) 695-0063
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
125069614
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/22/2016
Last updated
03/09/2017
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