Provider Demographics
NPI:1164629317
Name:MATRE, LINDA MARIE (OT)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:MARIE
Last Name:MATRE
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2230 N ORCHARD ST
Mailing Address - Street 2:UNIT 403
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-6251
Mailing Address - Country:US
Mailing Address - Phone:773-244-3930
Mailing Address - Fax:
Practice Address - Street 1:550 W WEBSTER AVE
Practice Address - Street 2:DEPARTMENT OF REHABILITATION
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-3965
Practice Address - Country:US
Practice Address - Phone:773-883-2000
Practice Address - Fax:773-883-3883
Is Sole Proprietor?:No
Enumeration Date:2007-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist