person
Fidel Mata, PA
Medical Physician Assistant in Decatur, Illinois
NPI 1558445924

Fidel Mata is a Medical Physician Assistant based in Decatur, IL and is specialized in Medical. Fidel Mata practices in Decatur, IL and has the professional credentials of PA. The NPI Number for Fidel Mata is 1558445924 and holds a License No. 085.002235 (Illinois).

The current practice location address for Fidel Mata is 1770 E Lake Shore Dr Ste 105, Decatur, IL and can be reached out via phone at 217-422-6100 and via fax at 833-784-5326.

Location: 1770 E Lake Shore Dr Ste 105, Decatur, IL, 62521-3800
person
Provider Profile Details
NPI Number
1558445924
Provider Name
Fidel Mata
Credential
PA
Provider Entity Type
Individual
Gender
Male
Address
1770 E Lake Shore Dr Ste 105, Decatur, IL, 62521-3800
Phone Number
217-422-6100
Fax Number
833-784-5326
Provider Enumeration Date
10/24/2006
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
1770 E Lake Shore Dr Ste 105
City
State
Zip
62521-3800
Phone Number
217-422-6100
Fax Number
833-784-5326
person
Provider Business Mailing Address Details
Address
1770 E Lake Shore Dr Ste 105
City
State
Zip
62521-3800
Phone Number
217-422-6100
Fax Number
833-784-5326
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Internal Medicine
Speciality
Cardiovascular Disease
Taxonomy
License No.
085-002235 (Illinois)
Definition
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
person
Provider's Taxonomy Details 2
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
085.002235 (Illinois)
Definition
Definition to come...
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