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NPI Code Detail

MEDICARE: REBECCA S MATTESON LPT

MEDICARE: REBECCA S MATTESON LPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist070-013899IL

General Provider Information

NPI Number : 1457437170
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA S MATTESON LPT
Provider Business Mailing Address
First Line : PO BOX 72180
Second Line :
City : ROSELLE
State : IL
Zip : 60172-0180
Country : US
Telephone Number : 630-924-0156
Fax Number : 630-924-0462
Provider Business Practice Location Address
First Line : 3115 LEWIS AVE
Second Line :
City : ZION
State : IL
Zip : 60099-3099
Country : US
Telephone Number : 630-924-0156
Fax Number : 847-362-9486
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/27/2006
Last Update Date : 10/29/2020

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Directions to “ REBECCA S MATTESON LPT” Practice Location

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