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General NPI Number Information
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NPI Number | 1396094959
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Entity Type | Organization
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Legal Business Name | MATTER CLINICAL SERVICES, P.C.
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Dates
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Enumeration Date | 08/29/2012
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Last Update Date | 08/29/2012
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Provider Practice Location Address
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Address Line | 475 RIVER BEND ROAD SUITE 304
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City | NAPERVILLE
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State | IL
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Zip | 60540
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Country | US
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Telephone | 630-778-9050
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Fax | 630-778-9054
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Provider Business Mailing Address
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Address Line | 475 RIVER BEND ROAD SUITE 304
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City | NAPERVILLE
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State | IL
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Zip | 60540
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Country | US
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Telephone | 630-778-9050
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Fax | 630-778-9054
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Authorized Official
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Title or Position | PRESIDENT
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Name | JAMES RAYMOND MATTER
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Credential | PSY.D.
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Telephone | 630-778-9050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 071008340
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License Number State | IL
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