Provider Demographics
NPI:1083794457
Name:SKARBEK, MATTHEW EDWARD (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:EDWARD
Last Name:SKARBEK
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1621 CLYDE DR
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60565-2303
Mailing Address - Country:US
Mailing Address - Phone:630-369-2889
Mailing Address - Fax:
Practice Address - Street 1:301 SPRINGFIELD AVE
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-6590
Practice Address - Country:US
Practice Address - Phone:630-369-2889
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL09932197OtherBCBSIL
IL238208OtherCOMPSYCH
ILK11647Medicaid