Provider Demographics
NPI:1518323112
Name:MATOUSEK, SAXONY A (PT)
Entity Type:Individual
Prefix:
First Name:SAXONY
Middle Name:A
Last Name:MATOUSEK
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:183 N YORK ST
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-2717
Mailing Address - Country:US
Mailing Address - Phone:630-832-6919
Mailing Address - Fax:630-832-6928
Practice Address - Street 1:8750 W BRYN MAWR
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60631-3569
Practice Address - Country:US
Practice Address - Phone:630-832-6919
Practice Address - Fax:630-832-6928
Is Sole Proprietor?:No
Enumeration Date:2016-01-12
Last Update Date:2016-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0700219542251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic