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General NPI Number Information
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NPI Number | 1376636027
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Entity Type | Organization
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Legal Business Name | MARTIN M MATUS OD
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 08/11/2015
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Provider Practice Location Address
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Address Line | 1046 S ARLINGTON HEIGHTS RD
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City | ARLINGTON HEIGHTS
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State | IL
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Zip | 60005-3139
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Country | US
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Telephone | 847-290-1131
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Fax | 847-290-1146
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Provider Business Mailing Address
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Address Line | 1046 S ARLINGTON HEIGHTS RD
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City | ARLINGTON HEIGHTS
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State | IL
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Zip | 60005-3139
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Country | US
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Telephone | 847-290-1131
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Fax | 847-290-1146
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Authorized Official
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Title or Position | INSURANCE BILLER
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Name | CORINNE GORMAN
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Credential |
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Telephone | 847-293-7833
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 046-009573
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 046-008214
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License Number State | IL
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