Individual
DR. MATTHEW EDWIN HENRIQUES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1611 W HARRISON ST STE 400, CHICAGO, IL 60612-4861
(877) 632-6637
(708) 409-5179
Mailing address
1611 W HARRISON ST STE 400, CHICAGO, IL 60612-4861
(877) 632-6637
(708) 409-5179
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
—
—
207X00000X
Orthopaedic Surgery Physician
01092564A
IN
207X00000X
Orthopaedic Surgery Physician
Primary
036168247
IL
Other
Enumeration date
04/04/2019
Last updated
06/24/2024
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