Mathers, Leslie

Mathers, Leslie is an individual health care provider with primary practice located at 1701 E College Ave , Bloomington IL 61704-2101. He recently has only one registered license in Allopathic & Osteopathic Physicians / Occupational Medicine, which is considered as his primary health care specialty. Mathers, Leslie can be contacted via phone (309) 664-3038.

Contact Information

Primary practice address
1701 E College Ave Bloomington IL 61704-2101
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Occupational Medicine 2083X0100X 036055260 Illinois

Profile Details

NPI number 1487675161
LBN Legal business name Mathers, Leslie
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 21st, 2006
Last updated Nov 17th, 2009 - about 16 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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Identifiers

StateTypeNumberIssuer
All States NPI 1487675161 NPPES
Illinois Other IL2613 MEDICARE GROUP PTAN

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