Individual
HENRY MATTIS
Active
Individual
HENRY MATTIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
036061332
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0360613321
—
IL
01
—
060009692
RR MEDICARE
—
01
—
096884
HEALTH ALLIANCE
—
01
—
117064
HEALTHLINK
—
01
—
12475
ESSENCE
—
01
—
1413735
UHC
—
01
—
16272
BCBS MO
MO
01
—
237612
WELLCARE
—
01
—
2507183
SECURE HORIZONS
—
01
—
3709969003
GHP
—
01
—
42932
CMR
—
01
—
C41352
MERCY
—
Enumeration date
07/03/2006
Last updated
07/05/2012
Update your record
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