Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | 036133384 | IL |
NPI | 1144475435 |
---|---|
Provider Name | Dr. Matthew Co |
First Address | Glenview, IL 60026-1339 |
Second Address | Skokie, IL 60076-1214 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/12/2008 |
Last Update Date | 03/03/2021 |