Matejka, Glen T

Matejka, Glen T is an sole proprietor health care provider with primary practice located at 7105 Virginia Rd Suite 15, Crystal Lake IL 60014-7985. He recently has 2 registered licenses in different health care specialties including Chiropractic Providers / Chiropractor, Chiropractic Providers / Nutrition. Chiropractic Providers / Chiropractor is his primary health care specialty. Matejka, Glen T can be contacted via phone (815) 455-4500.

Contact Information

Primary practice address
7105 Virginia Rd Suite 15 Crystal Lake IL 60014-7985
Phone: (815) 455-4500
Fax: (815) 455-4529
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X 038007434 Illinois
Chiropractic Providers / Nutrition 111NN1001X 164003999 Illinois

Profile Details

NPI number 1366404568
LBN Legal business name Matejka, Glen T
Credentials DN DC DACBN CCN
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 4th, 2006
Last updated May 29th, 2008 - about 16 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 1366404568 NPPES
Illinois Other 05605168 BCBS IL

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