Christine Marie Mata M.D.

NPI 1891099420 - Ophthalmology - 207W00000X

NPI Details
NPI 1891099420
Gender Female
Enumeration Date 12/21/2010
Last Updated 06/26/2014
Entity Type Individual
Active Over 5 years ago
Practice Location
310 S GREENLEAF ST
SUITE 209
GURNEE IL, 60031-5708, US
Phone (847) 244-1657
Fax
Business Location
2126 W VAN BUREN ST
UNIT #4
CHICAGO IL, 60612-3211, US
Phone (847) 567-8216
Fax
Toxanomy
Taxonomy Code 207W00000X
License State Illinois
License Number 036.135571
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According to our database, Dr. Christine Marie Mata M.D. NPI is 1891099420, taxonomy code is 207W00000X and license number is 036.135571, license state is located at Illinois. Christine Marie Mata M.D. physically located at 310 S Greenleaf St, Gurnee IL, 60031-5708. NPI Number Christine Marie Mata M.D. has the Individual type.

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1891099420 NPI number is provided on an as is basis without warranty of any kind. 1891099420 is maintained by the National Plan & Provider Enumeration System. The contents of Christine Marie Mata M.D. are for informational purposes only.