Individual
DR. EDWIN ROY MATHEWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
15 FOUNDERS LN STE 100, JACKSONVILLE, IL 62650-3924
(217) 243-0300
(217) 245-6775
Mailing address
15 FOUNDERS LN STE 100, JACKSONVILLE, IL 62650-3924
(217) 243-0300
(217) 245-6775
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036.165011
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036.165011
MD LICENSE
IL
Enumeration date
04/10/2020
Last updated
10/23/2023
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