Provider Demographics
NPI:1629950043
Name:GRAY-MATTHEWS, COSANDRA F
Entity type:Individual
Prefix:
First Name:COSANDRA
Middle Name:F
Last Name:GRAY-MATTHEWS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14108 S REEVES RD
Mailing Address - Street 2:
Mailing Address - City:ROBBINS
Mailing Address - State:IL
Mailing Address - Zip Code:60472-2250
Mailing Address - Country:US
Mailing Address - Phone:708-852-8680
Mailing Address - Fax:
Practice Address - Street 1:14108 S REEVES RD
Practice Address - Street 2:
Practice Address - City:ROBBINS
Practice Address - State:IL
Practice Address - Zip Code:60472-2250
Practice Address - Country:US
Practice Address - Phone:708-852-8680
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-24
Last Update Date:2025-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider