Individual
MATTHEW J FRAZIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3259 S WELLS STREET, CHICAGO, IL 60616
(630) 290-4409
Mailing address
3259 S WELLS ST, CHICAGO, IL 60616-3619
(312) 225-5785
(312) 225-6103
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036129522
IL
207Q00000X
Family Medicine Physician
125055960
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036129522
—
IL
Enumeration date
06/08/2009
Last updated
12/27/2021
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