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Contact Information

MATTHEW R BODETT
2714 W PETERSON AVE
CHICAGO, IL60659-3920
 Phone: 208-921-9351
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community Health Worker

172V00000X
Indicates primary specialty

NPI Profile & details for MATTHEW R BODETT · (Male)

NPI Number 1881541829
Status Active
Credentials
Entity Individual
Enumeration date 03/10/2026
Last updated 03/10/2026 - About 3 months ago
Sole proprietor 1 No
Identifiers Not Available
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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