Healthcare Provider Details

I. General information

NPI: 1821265596
Provider Name (Legal Business Name): MATTHEW STEPHEN HALL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2008
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1015 N OAK PARK AVE
OAK PARK IL
60302-1325
US

IV. Provider business mailing address

1015 N OAK PARK AVE
OAK PARK IL
60302-1325
US

V. Phone/Fax

Practice location:
  • Phone: 937-272-5027
  • Fax:
Mailing address:
  • Phone: 937-272-5027
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: