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NPI Code Detail

MEDICARE: DR. NIBY MATHEW M.D.

MEDICARE: DR. NIBY MATHEW M.D.
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
1207Q00000XFamily Medicine Physician125-051772IL

General Provider Information

NPI Number : 1184869125
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NIBY MATHEW M.D.
Provider Business Mailing Address
First Line : 23120 S LAGRANGE RD
Second Line :
City : FRANKFORT
State : IL
Zip : 60423-7760
Country : US
Telephone Number : 815-464-5440
Fax Number :
Provider Business Practice Location Address
First Line : 23120 S LAGRANGE RD
Second Line :
City : FRANKFORT
State : IL
Zip : 60423-7760
Country : US
Telephone Number : 815-464-5440
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/04/2008
Last Update Date : 05/28/2026

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Directions to “ DR. NIBY MATHEW M.D.” Practice Location

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