Basic Information
| Provider Information | |||||||||
| NPI: | 1376566539 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MATHEIS-SOLIMAN | ||||||||
| FirstName: | AMY | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1401 EAST 12TH STREET | ||||||||
| Address2: | |||||||||
| City: | MENDOTA | ||||||||
| State: | IL | ||||||||
| PostalCode: | 613429216 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8155397461 | ||||||||
| FaxNumber: | 8155385516 | ||||||||
| Practice Location | |||||||||
| Address1: | 1405 EAST 12TH STREET | ||||||||
| Address2: | SUITE 600 | ||||||||
| City: | MENDOTA | ||||||||
| State: | IL | ||||||||
| PostalCode: | 613429216 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8155387200 | ||||||||
| FaxNumber: | 8155391718 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/26/2006 | ||||||||
| LastUpdateDate: | 12/27/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 036-116774 | IL | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.