MEDICARE: TINA M. MATHEW APN-CNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	209016559	IL

General Provider Information

NPI Number	:	1730699778
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TINA M. MATHEW APN-CNP

Provider Business Mailing Address
First Line	:	880 W CENTRAL RD STE 5000
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60005-2384
Country	:	US
Telephone Number	:	847-618-3800
Fax Number	:	847-618-3809

Provider Business Practice Location Address
First Line	:	880 W CENTRAL RD STE 5000
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60005-2384
Country	:	US
Telephone Number	:	847-618-3800
Fax Number	:	847-618-3809

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/04/2017
Last Update Date	:	07/17/2024

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