Provider Demographics
NPI:1982720082
Name:MATSUSHITA, MASAHIKO (DC)
Entity Type:Individual
Prefix:DR
First Name:MASAHIKO
Middle Name:
Last Name:MATSUSHITA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 E GOLF RD
Mailing Address - Street 2:UNIT G,
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-4088
Mailing Address - Country:US
Mailing Address - Phone:847-290-9226
Mailing Address - Fax:847-290-9228
Practice Address - Street 1:505 E GOLF RD
Practice Address - Street 2:UNIT G,
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-4088
Practice Address - Country:US
Practice Address - Phone:847-290-9226
Practice Address - Fax:847-290-9228
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor