Doctor Name: | CARLOS MATOS |
NPI Number: | 1023425360 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 227008631 |
Business Practice Address: | 5215 N Ravenswood Ave Suite 105 Chicago, IL - 606401668 |
Business Phone Number: | 7738787330 |
Business Fax Number: | |
Mailing Address: | 5022 N Parkside Ave, CHICAGO |
State: | IL |
Postal Code: | 606304633 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 07/18/2014 |
NPI Last Update Date: | 07/18/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | 227008631 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |