Provider Demographics
NPI:1801960356
Name:MATTHES, RENEE ANNE (DC)
Entity type:Individual
Prefix:DR
First Name:RENEE
Middle Name:ANNE
Last Name:MATTHES
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5514 TENNESSEE AVE
Mailing Address - Street 2:
Mailing Address - City:CLARENDON HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60514-1512
Mailing Address - Country:US
Mailing Address - Phone:312-208-3243
Mailing Address - Fax:
Practice Address - Street 1:5514 TENNESSEE AVE
Practice Address - Street 2:
Practice Address - City:CLARENDON HILLS
Practice Address - State:IL
Practice Address - Zip Code:60514-1512
Practice Address - Country:US
Practice Address - Phone:312-208-3243
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2016-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038010642111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor