Robert Francis Matthews, D.D.S.
Individual provider Active NPI General Practice Dentistry · Alsip, IL
NPI 1194951392 · NPPES record last updated Jun 2, 2009
Key facts
- NPI
- 1194951392
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 019-016442 (IL)
- Practice address
- 11638B S Pulaski Rd
Alsip, IL 60803-1612 - Phone
- (708) 396-0060
- NPI assigned
- Jun 2, 2009
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160331001061 | IL | Order and Referring Only - Dentist |
1355648619 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019-016442 | IL | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 019-016442 | IL | Yes |
Addresses
Primary practice location
11638B S Pulaski Rd
Alsip, IL 60803-1612
Mailing address
11638B S Pulaski Rd
Alsip, IL 60803-1612
Phone (708) 396-0060
Other providers in Alsip, IL
- Benjamin L Lockwood
- LP Reliable Transportation
- Jessica A Mandac
- Elisha Ryaan Mason
- Brandy Matthews
- Antonia McCann
- Quintet Nyessie McKinley
- Sean Charles McNamee
- Caroline Nora McNicholas
- Gwen Elizabeth Medrano
All providers in Alsip, IL · General Practice Dentistry in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 2, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.