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NPI Code Detail

MEDICARE: DR. MATTHEW ROBERT WINSTANLEY PSY.D.

MEDICARE:  DR. MATTHEW ROBERT WINSTANLEY  PSY.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical PsychologistIL

General Provider Information

NPI Number : 1225175151
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MATTHEW ROBERT WINSTANLEY PSY.D.
Provider Business Mailing Address
First Line : 858 W ARMITAGE AVE
Second Line : UNIT #223
City : CHICAGO
State : IL
Zip : 60614-4370
Country : US
Telephone Number : 773-490-4885
Fax Number : 312-222-1771
Provider Business Practice Location Address
First Line : 405 N WABASH AVE
Second Line : SUITE 3805
City : CHICAGO
State : IL
Zip : 60611-3591
Country : US
Telephone Number : 773-490-4885
Fax Number : 312-222-1771
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/31/2007
Last Update Date : 07/08/2007

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