Healthcare Provider Details

I. General information

NPI: 1689446650
Provider Name (Legal Business Name): MONICA MATEI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/24/2023
Last Update Date: 10/26/2023
Certification Date: 10/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 PFINGSTEN RD
GLENVIEW IL
60026-1301
US

IV. Provider business mailing address

1595 ASHLAND AVE APT 204
DES PLAINES IL
60016-6672
US

V. Phone/Fax

Practice location:
  • Phone: 847-657-5800
  • Fax:
Mailing address:
  • Phone: 847-894-7623
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number041369477
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: