Provider Demographics
NPI:1720573157
Name:SERAFIN, MATTHEW (MD)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:SERAFIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 WAUKEGAN RD STE 200
Mailing Address - Street 2:
Mailing Address - City:NORTHFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60093-2724
Mailing Address - Country:US
Mailing Address - Phone:847-242-6600
Mailing Address - Fax:847-242-6605
Practice Address - Street 1:211 WAUKEGAN RD STE 200
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:IL
Practice Address - Zip Code:60093-2724
Practice Address - Country:US
Practice Address - Phone:847-242-6600
Practice Address - Fax:847-242-6605
Is Sole Proprietor?:No
Enumeration Date:2018-06-27
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.154223207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine