Fidel Mata, PA
Fidel Mata, PA is a Physician Assistant in Decatur, Illinois. Qualified in 2002, 24 years ago. Practices with Prairie Cardiovascular Consultants Ltd, a 94-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Illinois.
- Years since qualifying
- 24
- Licensed in
- IL
- In the registry since
- 2006
- Specialties on file
- 2
What do these letters mean?
- PA — Physician Assistant
- A licensed clinician who examines, diagnoses and treats under a physician's supervision.
Practice location Address checks out
1770 E Lake Shore Dr Ste 105Decatur, IL 62521-3800
Phone: (217) 422-6100
Fax: (833) 784-5326
Show map & directions
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Additional practice locations (1)
- 1800 E Lake Shore Dr, Decatur, IL 62521-3810 — (217) 422-6100
Specialties & licences
| Medical Physician Assistant (primary) | Taxonomy 363AM0700X · Licence 085-002235 (IL) |
|---|---|
| Cardiovascular Disease Physician | Taxonomy 207RC0000X · Licence 085.002235 (IL) |
Record details
| NPI number | 1558445924 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | PA |
| Sole proprietor | No |
| NPI enumerated | October 24, 2006 |
| Last updated in NPPES | December 20, 2021 |
| Certification date | December 20, 2021 |
| Mailing address | 1770 E Lake Shore Dr Ste 105, Decatur, IL 62521-3800 |
Medicare enrollment
| Medicare specialty | PHYSICIAN ASSISTANT |
|---|---|
| Medical school | OTHER |
| Graduated | 2002 (24 years in practice) |
| Group practice | Prairie Cardiovascular Consultants Ltd — 94 clinicians |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |
| Practice locations | 2 on file with Medicare |
Other providers in Decatur
-
Nakeya Khozema Dewaswala, MD
2300 N Edward St Ste 2400, Decatur, IL 62526-4163 · (217) 876-2400
-
Emily Ann Foster, FNP
1770 E Lake Shore Dr Ste 105, Decatur, IL 62521-3800 · (217) 422-6100
-
Dr. Jeanne Marie Kairouz, MD
1770 E Lake Shore Dr Ste 105, Decatur, IL 62521-3800 · (217) 422-6100
-
Bernard B Lim, MD
2300 N Edward St Ste 2400, Decatur, IL 62526-4163 · (217) 876-2400
-
Dr. Patrick B Murphy, MD
1770 E Lake Shore Dr Ste 105, Decatur, IL 62521-3800 · (217) 422-6100
-
Ellen M Zindel, NP
1770 E Lake Shore Dr Ste 105, Decatur, IL 62521-3800 · (217) 422-6100