MEDICARE: DR. MATTHEW NOBLE ALDER MD

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	208000000X	Pediatrics Physician	2023031811	MO
2	2080P0203X	Pediatric Critical Care Medicine Physician	2023031811	MO

General Provider Information

NPI Number	:	1609019470
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MATTHEW NOBLE ALDER MD

Provider Business Mailing Address
First Line	:	PO BOX 7412011
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60674-2011
Country	:	US
Telephone Number	:	417-269-4850
Fax Number	:	417-269-4852

Provider Business Practice Location Address
First Line	:	3801 S NATIONAL AVE
Second Line	:	DIV PED CRITICAL CARE MED, STE 1200
City	:	SPRINGFIELD
State	:	MO
Zip	:	65807-5210
Country	:	US
Telephone Number	:	417-269-4850
Fax Number	:	417-269-4852

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

Provider Enumeration Date	:	04/09/2009
Last Update Date	:	04/14/2026

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