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General NPI Number Information
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NPI Number | 1689913337
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Entity Type | Organization
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Legal Business Name | MATHES PODIATRY LTD.
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Dates
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Enumeration Date | 01/31/2013
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Last Update Date | 03/13/2019
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Provider Practice Location Address
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Address Line | 6311 W 95TH ST
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City | OAK LAWN
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State | IL
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Zip | 60453-2201
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Country | US
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Telephone | 708-636-4022
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Fax | 708-636-4105
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Provider Business Mailing Address
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Address Line | 6311 W 95TH ST
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City | OAK LAWN
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State | IL
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Zip | 60453-2201
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Country | US
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Telephone | 708-636-4022
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Fax | 708-636-4105
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Authorized Official
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Title or Position | OWNER
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Name | DR. KATHLEEN D. MATHES
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Credential | DPM
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Telephone | 708-636-4022
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State | IL
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