Leslie Mathers III, M.D.

Primary specialty

Occupational Medicine PhysicianTaxonomy code 2083X0100X

License

036055260 Issued in IL

Practice address

1701 E College Ave
Bloomington, IL 61704-2101

Phone

(309) 664-3038

NPI assigned

Jul 21, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258416000000",
    "number": "1487675161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 W UNIVERSITY AVE",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618012530",
            "telephone_number": "217-383-3311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 E COLLEGE AVE",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617042101",
            "telephone_number": "309-664-3038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHERS",
        "first_name": "LESLIE",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2009-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "IL",
            "license": "036055260",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN",
            "identifier": "IL2613",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kenneth B Masi, PHD,
• Rebekah Anne Mason, PA-C
• Massage by Megan
• George Massey
• Sarah S Masters
• Jacqueline Renee Mathias
• Kimberly Lynn Matthews
• Valerie A Mattsey
• Rachel Maxwell, CNP
• Zachariah Maxwell, PHARMD

• Occupational Medicine Physician in Bloomington, IL
• Providers in Bloomington, IL by specialty
• Occupational Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 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.

Verify at the official NPI Registry.