Individual
LIJI MATHEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2100 GLENWOOD AVENUE, JOLIET, IL 60435
(815) 725-2121
(815) 741-6303
Mailing address
PO BOX 713260, CHICAGO, IL 60677-1260
(630) 469-9200
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
36101622
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36101622
—
IL
Enumeration date
06/14/2006
Last updated
08/16/2023
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