| Doctor Name: | MR. MATTHEW THOMAS CARLSON |
| NPI Number: | 1073640413 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MPT |
| License Number: | 70012540 |
| Business Practice Address: | 9826 S Western Ave Evergreen Park, IL - 608053200 |
| Business Phone Number: | 7089528220 |
| Business Fax Number: | 7084235281 |
| Mailing Address: | 3720 W 111th St, Unit 404 CHICAGO |
| State: | IL |
| Postal Code: | 606554005 |
| Phone Number: | 7089528220 |
| Fax Number: | 7084235281 |
| NPI Enumeration Date: | 02/27/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 70012540 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |