Individual provider Active NPI

Tessie Thomas Mathew, D.O.

  • Family Medicine Physician
  • Wheaton, IL
National Provider Identifier
1285950287
Registry record updated Aug 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
3129427030 Issued in IL
Practice address
150 E Willow Ave Ste 300
Wheaton, IL 60187-5529
Phone
(630) 510-6900
Fax
(630) 871-6706
NPI assigned
Apr 15, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 3129427030 IL Primary

Addresses

Primary practice location

150 E Willow Ave Ste 300
Wheaton, IL 60187-5529

Mailing address

PO Box 713260
Chicago, IL 60677-1260
Phone (630) 469-9200

Other identifiers 1

IdentifierTypeStateIssuer
036132711MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tmathew44683@dulyhealthandcare.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141107001505 IL Practitioner - Geriatric Medicine 2365664232 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Geriatric Medicine
Education
Rush Medical College of Rush University, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dupage Medical Group LTDGroup PAC ID 5496667941, 1,326 clinicians
Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians

Practice addresses (Care Compare)

1325 N Meacham Rd
Schaumburg, IL 60173-4824
Phone (630) 469-9200

17495 La Grange Rd
Tinley Park, IL 60487-7581
Phone (708) 226-7000

2100 Glenwood Ave
Joliet, IL 60435-5487
Phone (815) 725-2121

25 N Winfield Rd
Winfield, IL 60190-1222

2600 Compass Rd
Glenview, IL 60026-8001

30 Stratford Dr
Bloomingdale, IL 60108-2201
Phone (630) 893-2210

40 S Clay St
Hinsdale, IL 60521-3257

430 Pennsylvania Ave
Glen Ellyn, IL 60137-4464
Phone (630) 469-9200

430 Warrenville Rd
Suite 210
Lisle, IL 60532-1348
Phone (630) 432-6180

560 Belmont LN
Carol Stream, IL 60188-2441
Phone (630) 665-6500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
3129427030ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Physician Group Family Medicine CurrentSince Mar 1, 2020 Accepting new patients
Dupage Medical Group LTD CurrentSince Jun 23, 2014 Accepting new patients
Dupage Medical Group LTD CurrentSince Jun 23, 2014 Accepting new patients
Central Dupage Physician Group CurrentSince Mar 1, 2020 Accepting new patients

Locations

30 Stratford Dr
Bloomingdale, IL 60108
Phone (630) 893-2210

Dept 5777
Carol Stream, IL 60122

560 Belmont Ln
Carol Stream, IL 60188
Phone (630) 588-9789

1860 Paysphere Cir
Chicago, IL 60674
Phone (630) 469-2000

150 E Willow Ave
Ste 300
Wheaton, IL 60187
Phone (630) 510-6900

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

150 E Willow Ave
Wheaton, IL 60187
Phone (630) 433-6991

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1271289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692144000000",
    "number": "1285950287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 713260",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606771260",
            "telephone_number": "630-469-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 E WILLOW AVE STE 300",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601875529",
            "telephone_number": "630-510-6900",
            "fax_number": "630-871-6706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHEW",
        "first_name": "TESSIE",
        "middle_name": "THOMAS",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-15",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "3129427030",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036132711",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tmathew44683@dulyhealthandcare.direct-ci.com",
            "affiliation": "N",
            "address_1": "150 E Willow Ave Ste 300",
            "city": "Wheaton",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601875529",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wheaton, IL

Sources for this page

Verify at the official NPI Registry.