Kathleen Gael Matay, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

041235961 Issued in IL

Practice address

12565 Renaissance Cir
Homer Glen, IL 60491-5898

Phone

(708) 590-5112

Fax

(708) 590-5074

NPI assigned

Aug 2, 2021

Last updated

Aug 2, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1627862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627862400000",
    "number": "1124792361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12565 RENAISSANCE CIR",
            "city": "HOMER GLEN",
            "state": "IL",
            "postal_code": "604915898",
            "telephone_number": "708-590-5112",
            "fax_number": "708-590-5074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12565 RENAISSANCE CIR",
            "city": "HOMER GLEN",
            "state": "IL",
            "postal_code": "604915898",
            "telephone_number": "708-590-5112",
            "fax_number": "708-590-5074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATAY",
        "first_name": "KATHLEEN",
        "middle_name": "GAEL",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-02",
        "last_updated": "2021-08-02",
        "certification_date": "2021-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041235961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Registered Nurse in Homer Glen, IL
• Providers in Homer Glen, IL by specialty
• Registered Nurse in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.