MEDICARE: MATTHEW CARR

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
1	101YP2500X	Professional Counselor	178.022498	IL

General Provider Information

NPI Number	:	1528911047
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW CARR

Provider Business Mailing Address
First Line	:	1934 N WASHTENAW AVE APT 205
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60647-7132
Country	:	US
Telephone Number	:	415-215-5663
Fax Number	:

Provider Business Practice Location Address
First Line	:	15 SPINNING WHEEL RD STE 118
Second Line	:
City	:	HINSDALE
State	:	IL
Zip	:	60521-2983
Country	:	US
Telephone Number	:	630-453-1792
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/16/2026
Last Update Date	:	02/16/2026

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