Windham, Matt

Windham, Matt is an sole proprietor health care provider with primary practice located at 2056 E 71St St , Chicago IL 60649-2117. He recently has only one registered license in Other Service Providers / Contractor, which is considered as his primary health care specialty. Windham, Matt can be contacted via phone (773) 288-2844.

Contact Information

Primary practice address
2056 E 71St St Chicago IL 60649-2117
Fax: (773) 288-2848
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Contractor 171W00000X

Profile Details

NPI number 1790886398
LBN Legal business name Windham, Matt
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 26th, 2006
Last updated Jul 8th, 2007 - about 17 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 1790886398 NPPES
Illinois Other V797P-4898A NATIONAL ACQUISTION VA

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