Amy M Matheis-Soliman, DO
Individual provider Active NPI Family Medicine Physician · Mendota, IL
NPI 1376566539 · NPPES record last updated May 22, 2024
Key facts
- NPI
- 1376566539
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 036-116774 (IL)
- Practice address
- 1405 East 12TH Street
Suite 600
Mendota, IL 61342-9216 - Phone
- (815) 538-7200
- Fax
- (815) 539-1718
- NPI assigned
- Jul 26, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 14
Hospital & facility affiliations 6
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Midwestern University, Chicago College of Osteopathic Med, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Mendota Community Hospital
Practice addresses (Care Compare)
1401 E 12TH St
Mendota, IL 61342-9216
Phone (815) 539-7461
Hospital & facility affiliations
- Osf Healthcare Home Care
- Osf Saint Paul Medical Center
- Osf Saint Elizabeth MDL Ctr
- Osf Saint Clare Medical Center
- Saint Francis Medical Center
- Saint Anthony Medical Center
- Osf Saint Paul Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060830000290 | IL | Practitioner - Family Practice | 8325042500 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-116774 | IL | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mendota Community Hospital | Family Medicine | Current | Accepting new patients |
| Ottawa Regional Hospital & Healthcare Center | Current | Accepting new patients | |
| Central PA Pharmacy LLC. | Current | Accepting new patients | |
| Mendota Community Hospital | Current |
Accepting new patients | |
| Mendota Community Hospital | Current |
Accepting new patients | |
| Osf Multi-Specialty Group | Current |
Accepting new patients | |
| Ottawa Regional Hospital & Healthcare Center | Family Medicine | Current |
Accepting new patients |
Locations
1401 E 12th St
Mendota, IL 61342
Phone (815) 539-7461
1404 Washington St
Mendota, IL 61342
Phone (815) 538-1825
1405 E 12th St
Mendota, IL 61342
Phone (815) 538-2031
1405 E 12th St
Ste 600
Mendota, IL 61342
Phone (815) 538-7200
1100 E Norris Dr
Ottawa, IL 61350
Phone (815) 416-1224
1614 E Norris Dr
Ottawa, IL 61350
Phone (815) 433-1010
8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 036-116774 | IL | Yes |
Addresses
Primary practice location
1405 East 12TH Street
Suite 600
Mendota, IL 61342-9216
Mailing address
1401 East 12TH Street
Mendota, IL 61342-9216
Phone (815) 539-7461
Other providers in Mendota, IL
- Jon C Krenz
- Marcela Renee Lemus
- Leonardo Lopez
- Cara Elizabeth Ludwick
- Jonathan Mata
- Judith A. McConville
- Mendota C C School Dist 289
- Mendota Community Hospital
- Mendota Community Hospital
- Mendota Community Hospital
All providers in Mendota, IL · Family Medicine Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 22, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.