Basic Information
| Provider Information | |||||||||
| NPI: | 1760703771 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PATTON | ||||||||
| FirstName: | MATTHEW | ||||||||
| MiddleName: | STEVEN | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 400 N MCCLURG CT | ||||||||
| Address2: | APT. 1211 | ||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606114323 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6513365403 | ||||||||
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| Practice Location | |||||||||
| Address1: | 420 E SUPERIOR ST | ||||||||
| Address2: | RUBLOFF BUILDING, 12TH FLOOR | ||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606114494 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3126947000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/14/2010 | ||||||||
| LastUpdateDate: | 06/14/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 125-058607 | IL | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.