Healthcare Provider Details

I. General information

NPI: 1336155092
Provider Name (Legal Business Name): MATTHEW JOSEPH HYSER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 05/19/2025
Certification Date: 05/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 AUSTIN ST EAST TOWER, SUITE 563
EVANSTON IL
60202-3439
US

IV. Provider business mailing address

800 AUSTIN ST EAST TOWER, SUITE 563
EVANSTON IL
60202-3439
US

V. Phone/Fax

Practice location:
  • Phone: 847-869-0522
  • Fax: 847-869-0652
Mailing address:
  • Phone: 847-869-0522
  • Fax: 847-869-0652

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number036073532
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License Number036073532
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: