Samuelson, Matthew I
Samuelson, Matthew I is an individual health care provider with primary practice located at 420 N Il Route 31 , Crystal Lake IL 60012-3711. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Orthopaedic Surgery, Allopathic & Osteopathic Physicians / Foot and Ankle Surgery. Allopathic & Osteopathic Physicians / Foot and Ankle Surgery is his primary health care specialty. Samuelson, Matthew I can be contacted via phone (815) 356-5200.Contact Information
Primary practice address
420 N Il Route 31
Crystal Lake IL 60012-3711
Phone: (815) 356-5200
Fax: (815) 356-5262
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | 036086139 | Illinois |
| Allopathic & Osteopathic Physicians / Foot and Ankle Surgery | 207XX0004X | 036-086139 | Illinois |
Profile Details
| NPI number | 1568534147 |
|---|---|
| LBN Legal business name | Samuelson, Matthew I |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 15th, 2006 |
| Last updated | Aug 8th, 2017 - about 8 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 | 1568534147 | NPPES |
| Illinois | MEDICAID | 036086139 |
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