NPI 1023425360

Carlos Matos

Practitioner Massage Therapist Chicago, IL

Practice location

Address: 5215 N Ravenswood Ave Suite 105, Chicago, IL 60640-1668
Phone: (773) 878-7330
Mailing address: 5022 N Parkside Ave, Chicago, IL 60630-4633

Registered specialties

Massage Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225700000X Licence 227008631 (IL)

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Registry record

NPI: 1023425360
Entity type: Individual
Sex (as registered): Male
NPI issued: 18 Jul 2014
Record last updated: 18 Jul 2014

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.