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1801418975

NPI Code Detail

MEDICARE: JANELL MONEE MATHUS MD

MEDICARE: JANELL MONEE MATHUS 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	207Q00000X	Family Medicine Physician	346206	LA
2	207Q00000X	Family Medicine Physician	125076325	IL
3	207Q00000X	Family Medicine Physician	036-164281	IL

General Provider Information

NPI Number	:	1801418975
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANELL MONEE MATHUS MD

Provider Business Mailing Address
First Line	:	29373 NETWORK PL
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60673-1293
Country	:	US
Telephone Number	:	847-390-5900
Fax Number	:

Provider Business Practice Location Address
First Line	:	2210 W 95TH ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60643-1002
Country	:	US
Telephone Number	:	773-341-3500
Fax Number	:	773-341-6064

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

Provider Enumeration Date	:	05/12/2020
Last Update Date	:	06/09/2026

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Directions to “ JANELL MONEE MATHUS MD” Practice Location

Language	Start Address	Practice Location

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