NPI 1013384049

Tristan Sumpter

Practitioner Driver Matteson, IL

Practice location

Address: 6237 Sunflower Dr, Matteson, IL 60443-1417
Phone: (773) 240-2375

Registered specialties

Driver Primary

Other Service Providers Taxonomy 172A00000X Licence S51381289198 (IL)

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Registry record

NPI: 1013384049
Entity type: Individual
Sex (as registered): Male
NPI issued: 25 Aug 2015
Record last updated: 25 Aug 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.