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Contact Information

MATTHEW I SAMUELSON, MD
420 N IL ROUTE 31
CRYSTAL LAKE, IL60012-3711
 Phone: 815-356-5200
 Fax: 815-356-5262
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Foot and Ankle Surgery

207XX0004X 02 Physician/General Surgery
 

Orthopaedic Surgery

207X00000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for MATTHEW I SAMUELSON · (Male)

NPI Number 1568534147
Status Active
Credentials MD
Entity Individual
Enumeration date 11/15/2006
Last updated 08/08/2017 - About 9 years ago
Sole proprietor 1 No
Identifiers
  • IL License # 036-086139
  • IL License # 036086139
  • IL Medicaid 036086139
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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