Provider Demographics
NPI:1063689404
Name:SUNA MATARIEH AND ASSOCIATES PC
Entity Type:Organization
Organization Name:SUNA MATARIEH AND ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROFESSIONAL COUNSELOR/PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:SANA
Authorized Official - Middle Name:
Authorized Official - Last Name:MATARIEH
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:708-557-1112
Mailing Address - Street 1:7059 W 111TH ST
Mailing Address - Street 2:
Mailing Address - City:WORTH
Mailing Address - State:IL
Mailing Address - Zip Code:60482-1826
Mailing Address - Country:US
Mailing Address - Phone:708-557-1112
Mailing Address - Fax:
Practice Address - Street 1:7059 W 111TH ST
Practice Address - Street 2:SUITE B
Practice Address - City:WORTH
Practice Address - State:IL
Practice Address - Zip Code:60482-1826
Practice Address - Country:US
Practice Address - Phone:708-557-1112
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-14
Last Update Date:2008-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.006236101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty