Mata, Fidel

Mata, Fidel is an individual health care provider with primary practice located at 1770 E Lake Shore Dr Ste 105 , Decatur IL 62521-3800. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cardiovascular Disease, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Medical is his primary health care specialty. Mata, Fidel can be contacted via phone (217) 422-6100.

Contact Information

Primary practice address
1770 E Lake Shore Dr Ste 105 Decatur IL 62521-3800
Phone: (217) 422-6100
Fax: (833) 784-5326
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 085.002235 Illinois
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 085-002235 Illinois

Profile Details

NPI number 1558445924
LBN Legal business name Mata, Fidel
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 24th, 2006
Last updated Dec 20th, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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