Individual
MRS. DIANE FODOR MATTES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
5000 S 5TH AVE BLDG 1, ROOM E236, HINES, IL 60141-3030
(708) 202-8387
(708) 202-7402
Mailing address
5000 S. FIFTH AVE BUILDING 1, ROOM E236, HINES, IL 60141-3030
(708) 202-8387
(708) 202-7402
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209006217
IL
Other
Enumeration date
04/16/2007
Last updated
11/29/2021
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