Active NPI
Matthew Theodore Eakins, M.D.
- Internal Medicine Physician
- Maywood, IL
National Provider Identifier
1043447782
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 125.056322
- Practice address
- 2160 S 1St Ave
Suite 1739
Maywood, IL 60153-3328 - Phone
- (312) 636-7489
- NPI assigned
- Jun 21, 2009
- Last updated
- Jun 21, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 125.056322 | IL | Primary |
Addresses
Primary practice location
2160 S 1St Ave
Suite 1739
Maywood, IL 60153-3328
Mailing address
2160 S 1St Ave
Suite 1739
Maywood, IL 60153-3328
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 125.056322 | Other | IL | LICENSED MEDICAL TEMPORARY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 125.056322 | IL | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1245542400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1245542400000",
"number": "1043447782",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2160 S 1ST AVE",
"address_2": "SUITE 1739",
"city": "MAYWOOD",
"state": "IL",
"postal_code": "601533328"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2160 S 1ST AVE",
"address_2": "SUITE 1739",
"city": "MAYWOOD",
"state": "IL",
"postal_code": "601533328",
"telephone_number": "312-636-7489"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EAKINS",
"first_name": "MATTHEW",
"middle_name": "THEODORE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-06-21",
"last_updated": "2009-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IL",
"license": "125.056322",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSED MEDICAL TEMPORARY",
"identifier": "125.056322",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Maywood, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.