Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
FIDEL MATA, P.A.
ActiveFIDEL MATA, P.A. is a Medical Physician Assistant healthcare provider located in DECATUR, Illinois. NPI 1558445924 is currently active in the NPPES registry. Verify at CMS.
Medical Physician Assistant · DECATUR, IL
Registration Details
- NPI Number
- 1558445924
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Oct 24, 2006 (19.77441731624 yrs)
- Last Updated
- Dec 20, 2021
- Licenses
-
085.002235 (IL)085-002235 (IL)
Practice Information
- Address
-
1770 E LAKE SHORE DR STE 105DECATUR, IL, 625213800Browse IL providers · Browse ZIP 62521
- Phone
- 2174226100
- Fax
- 8337845326
- Primary Specialty
-
Medical Physician Assistant
363AM0700X
- Additional Specialty
- Medical Physician Assistant
Other Medical Physician Assistant Providers in DECATUR, IL
| Name | Credential | NPI |
|---|---|---|
| LAURA E LAW | PA-C | 1154308815 |
| MRS. MEGHAN ELIZABETH BAUMANN | PA-C | 1164479234 |
| MS. JULIE MARIE PRESTON | PA-C | 1306026224 |
| MR. ERIC MATTHEW CARRIER | P.A.-C | 1174756639 |
| MARY KATHERINE KENNEY | PA | 1003299082 |
| BETHANY MORGAN GEBUR | PA-C | 1043737448 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.