Mathen, Shaun Kuriakose
Mathen, Shaun Kuriakose is an individual health care provider with primary practice located at 8 Health Services Dr , Dekalb IL 60115-9647. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Mathen, Shaun Kuriakose can be contacted via phone (815) 754-0300.Contact Information
Primary practice address
8 Health Services Dr
Dekalb IL 60115-9647
Phone: (815) 754-0300
Fax: (815) 754-0400
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 036119224 | Illinois |
Profile Details
| NPI number | 1770744476 |
|---|---|
| LBN Legal business name | Mathen, Shaun Kuriakose |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 24th, 2008 |
| Last updated | May 12th, 2017 - about 7 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1770744476 | NPPES |
| Illinois | Other | IL2305006 | MEDICARE INDIVIDUAL |
| Illinois | MEDICAID | 036119224 | MEDICARE INDIVIDUAL |
| Illinois | Other | IL6309 | MEDICARE INDIVIDUAL |
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