Fred, Matthew

Fred, Matthew is an individual health care provider with primary practice located at 2135 W Ramada Ln , Carbondale IL 62901-5326. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Rehabilitation Counselor, which is considered as his primary health care specialty. Fred, Matthew can be contacted via phone (618) 457-3318.

Contact Information

Primary practice address
2135 W Ramada Ln Carbondale IL 62901-5326
Phone: (618) 457-3318
Fax: (618) 549-0132
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Rehabilitation Counselor 225C00000X

Profile Details

NPI number 1346512589
LBN Legal business name Fred, Matthew
Credentials M.S., CRC
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 3rd, 2012
Last updated Feb 3rd, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1346512589 NPPES
Illinois Other 00112331 CRC

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