Provider Demographics
NPI:1427127034
Name:MATTER, JAMES RAYMOND (PSYD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:RAYMOND
Last Name:MATTER
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:475 RIVER BEND RD
Mailing Address - Street 2:SUITE 304
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-5255
Mailing Address - Country:US
Mailing Address - Phone:630-778-9050
Mailing Address - Fax:630-778-9054
Practice Address - Street 1:475 RIVER BEND RD
Practice Address - Street 2:SUITE 304
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-5255
Practice Address - Country:US
Practice Address - Phone:630-778-9050
Practice Address - Fax:630-778-9054
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2016-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071.008340103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical