Individual
FIDEL MATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
1770 E LAKE SHORE DR STE 105, DECATUR, IL 62521-3800
(217) 422-6100
(833) 784-5326
Mailing address
1770 E LAKE SHORE DR STE 105, DECATUR, IL 62521-3800
(217) 422-6100
(833) 784-5326
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
085.002235
IL
363AM0700X
Medical Physician Assistant
Primary
085-002235
IL
Other
Enumeration date
10/24/2006
Last updated
12/20/2021
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us