MARK C MATRAY (NPI# 1225046287) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225046287 |
| Entity Type | Individual |
| Full Name | MARK C MATRAY |
| Credential | MD |
| Practice Address |
4727 Willow Springs Rd Lagrange IL 60525 |
| Practice Telephone | 7085880088 |
| Practice Fax Number | 7085880588 |
| Mailing Telephone | 7085880088 |
| Mailing Fax Number | 7085880588 |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BLUE SHIELD | 31600935 | 01 |
| Street Address |
4727 WILLOW SPRINGS RD |
| City | LAGRANGE |
| State | IL |
| Zip Code | 60525 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063923837 | Cheryl Buhrke | Speech-Language Pathologist | 1301 W. Cossitt Ave., La Grange, IL 60525 | 2017-10-19 |
| 1881113462 | Karen Aluise | Speech-Language Pathologist | 6818 Joliet Rd. #2, Indian Head Park, IL 60525 | 2017-09-14 |
| 1689126997 | Adriana Digianfilippo | Occupational Therapist | 18 N. Catherine, Lagrange, IL 60525 | 2016-11-03 |
| 1679953582 | Paulina Pinzon | Counselor | 6548 Laurel Avenue, Indian Head Park, IL 60525 | 2015-06-05 |
| 1639446925 | Aarti Parikh | Pharmacist | 6600 S. Willow Springs Rd, Indian Head Park, IL 60525 | 2011-11-30 |
| 1831476795 | Jessica E Feller | Physician Assistant | 6555 South Willow Springs Road, Suite 6, Countryside, IL 60525 | 2011-11-07 |
| 1477833218 | Robyn Lee Frendling | Behavioral Analyst | 9649 W. 55th St, Countryside, IL 60525 | 2011-08-25 |
| 1457630543 | Kerri E Kabela | Physical Therapist | 705 W. Plainfield Rd, Suite 1, Countryside, IL 60525 | 2011-08-08 |
| 1275826984 | G&u Orthopedic, LLC | Durable Medical Equipment & Medical Supplies | 106 W. Calendar Ave., 127, La Grange, IL 60525 | 2011-05-27 |
| 1952609752 | Athletic and Therapeutic Institute of Naperville, LLC | Physical Therapist | 705 W. Plainfield Road, Suite 1, Countryside, IL 60525 | 2011-03-03 |
| Find all providers in zip 60525 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427176536 | Pediatric Associates of Lagrange | Pediatrics | 1495 Lafayette Pkwy, Lagrange, GA 30241-2552 | 2007-03-27 |
| 1255443297 | George John Lechacz | Pediatrics | 1550 Doctors Dr, Suite 300, Lagrange, GA 30240-4140 | 2006-08-31 |
| 1336151489 | Julie Christine Tumma | Pediatrics | 4727 Willow Springs Road, Lagrange, IL 60525 | 2006-08-13 |
| 1609800705 | Lisa Pharis Allardice | Pediatrics | 205 Calumet Center Rd, Lagrange, GA 30241-6711 | 2006-07-11 |
| 1083613525 | Kalyani Rajeev | Pediatrics | 301 Medical Dr, Suite 504, Lagrange, GA 30240-4144 | 2005-07-18 |
| 1134416894 | Holly Mcmahon Dawson | Pediatrics | 1514 Vernon Rd, Lagrange, GA 30240-4131 | 2011-07-01 |
| 1275827396 | Torey Scott Harden | Pediatrics | 301 Medical Dr, Ste 504, Lagrange, GA 30240-4144 | 2011-06-06 |
| 1558590968 | Lacy R Tumambing | Pediatrics | 205 Calumet Center Rd, Lagrange, GA 30241-6711 | 2009-07-07 |
| 1659509685 | Cory C Butzon | Pediatrics | 1514 Vernon Rd, Lagrange, GA 30240-4131 | 2009-06-29 |
| 1720213952 | Kid Station Pediatrics P.c | Pediatrics | 301 Medical Dr, Suite 504, Lagrange, GA 30240-4144 | 2009-05-18 |
| Find all providers in LAGRANGE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.