Doctor Name: | JANIE LYN MATA |
NPI Number: | 1811258346 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PT |
License Number: | 070.015076 |
Business Practice Address: | 545 Belmont Ln Carol Stream, IL - 601882467 |
Business Phone Number: | 6305101515 |
Business Fax Number: | 6305100633 |
Mailing Address: | 23528 N. East Road, LAKE ZURICH |
State: | IL |
Postal Code: | 60047 |
Phone Number: | 8478779836 |
Fax Number: | 8472054645 |
NPI Enumeration Date: | 05/31/2012 |
NPI Last Update Date: | 11/02/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 070.015076 |
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 |