Individual
DR. MATIN NEKZAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1006 S DIVISION ST, CARTERVILLE, IL 62918-1539
(618) 985-4841
(618) 985-4535
Mailing address
PO BOX 577, CARTERVILLE, IL 62918-0577
(618) 985-8221
(618) 985-6860
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036098147
IL
2083B0002X
Obesity Medicine (Preventive Medicine) Physician
036.098147
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036098147
—
IL
05
—
370966854004
—
IL
01
—
CF3444
MEDICARE RAILROAD
IL
Enumeration date
02/22/2006
Last updated
06/04/2024
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