Dr Derek John Matoka, MD | |
2160 S 1st Ave, Building 54, Maywood, IL 60153-3328 | |
(708) 216-6266 | |
(708) 216-6585 |
Full Name | Dr Derek John Matoka |
---|---|
Gender | Male |
Speciality | Urology - Pediatric Urology |
Location | 2160 S 1st Ave, Maywood, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1316193824 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2088P0231X | Urology - Pediatric Urology | 036-121562 (Illinois) | Primary |
Entity Name | Rockford Health Physicians |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1043242886 PECOS PAC ID: 2567374036 Enrollment ID: O20031103000584 |
Entity Name | Loyola University Medical Center |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1336159961 PECOS PAC ID: 3779488903 Enrollment ID: O20031202000027 |
Mailing Address | Practice Location Address |
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Dr Derek John Matoka, MD 2160 S 1st Ave, Building 54, Maywood, IL 60153-3328 Ph: (708) 216-6266 | Dr Derek John Matoka, MD 2160 S 1st Ave, Building 54, Maywood, IL 60153-3328 Ph: (708) 216-6266 |
Timothy Moonhwan Han, MD Urology Medicare: Medicare Enrolled Practice Location: 2160 S 1st Ave, Maywood, IL 60153 Phone: 708-216-8467 | |
Dr. Liam Hatch, MD Urology Medicare: Medicare Enrolled Practice Location: 2160 S 1st Ave, Maywood, IL 60153 Phone: 708-216-6901 Fax: 708-216-6585 | |
Christopher Gonzalez, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 2160 S 1st Ave, Maywood, IL 60153 Phone: 708-216-9000 | |
Dr. Grace Bayudan Delos Santos, M.D. Urology Medicare: Accepting Medicare Assignments Practice Location: 2160 S 1st Ave, Loyola University Medical Center, Bldg 101, Room 1739, Maywood, IL 60153 Phone: 708-216-9000 | |
Gopal N. Gupta, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 2160 S 1st Ave, Fahey Center, Bldg 54, Maywood, IL 60153 Phone: 708-216-5098 Fax: 708-126-1699 | |
Dr. Ahmer V Farooq, D.O. Urology Medicare: Accepting Medicare Assignments Practice Location: 2160 S 1st Ave, Department Of Urology, Fahey Center Rm 260, Maywood, IL 60153 Phone: 708-216-5100 Fax: 708-216-8991 |