David Roy Matteson is a Clinical in Crete, Illinois. David Roy Matteson practices all healthcare services and medical treatments related to Clinical. The NPI Number for David Roy Matteson is 1811904311. The last update date is 2007-07-08.
David Roy Matteson's current location address is 2245 W Thorn Ln, Crete, Illinois. You can contact this provider via phone number 7086728807. The mailing address for David Roy Matteson is 2245 W Thorn Ln, Crete, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | David Roy Matteson |
|---|---|
| Address | 2245 W Thorn Ln, Crete, Illinois |
| Phone Number | 7086728807 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | PH.D. |
NPI Number Detail
| NPI Number | 1811904311 |
|---|---|
| Provider Enumeration Date | 2006-08-01 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 2245 W Thorn Ln |
|---|---|
| City | Crete |
| State | Illinois (IL) |
| Post Code | 604179657 |
| Phone Number | 7086728807 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 103Tc0700X |
| Licence No | 71002090 |
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Definition: A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 99-72013 | IL | BLUE CROSS PROVIDER |
Post Comment/ Review Below
What is the unique provider identifier assigned to David Roy Matteson?
The David Roy Matteson has been issued the NPI (National Provider Identifier) 1811904311 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you please provide the complete physical location address of David Roy Matteson?
The David Roy Matteson is physically situated at 2245 W Thorn Ln, in the city of Crete, state of IL, with the postal code 604179657.
What is the David Roy Matteson's area of specialization and corresponding taxonomy classification?
The David Roy Matteson's specialty field is Clinical, and it falls under the taxonomy code 103Tc0700X, which categorizes healthcare providers based on their specialties.
On what date did the Centers for Medicare & Medicaid Services assign the 1811904311 to David Roy Matteson?
The Centers for Medicare & Medicaid Services assigned the 1811904311 to David Roy Matteson on 2006-08-01.
When was the information regarding David Roy Matteson most recently updated?
The details pertaining to the David Roy Matteson, including its address, specialty, and other relevant information, were last refreshed on 2007-07-08.