Carl P Mattioda MD and Chaoming Chen MDSC

Primary specialty

Hospice and Palliative Medicine (Obstetrics & Gynecology) PhysicianTaxonomy code 207VH0002X

Legal business name

CARL P MATTIODA MD AND CHAOMING CHEN MDSC

Practice address

104 W 6TH St
Streator, IL 61364-2899

Phone

(815) 673-4363

Fax

(815) 672-2524

NPI assigned

May 14, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Carl P Mattioda, MC

Title

President

Phone

(815) 673-4363

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206662400000",
    "number": "1659586279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 W 6TH ST",
            "city": "STREATOR",
            "state": "IL",
            "postal_code": "613642899",
            "telephone_number": "815-673-4363",
            "fax_number": "815-672-2524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 W 6TH ST",
            "city": "STREATOR",
            "state": "IL",
            "postal_code": "613642899",
            "telephone_number": "815-673-4363",
            "fax_number": "815-672-2524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARL P MATTIODA MD AND CHAOMING CHEN MDSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-14",
        "last_updated": "2008-03-28",
        "status": "A",
        "authorized_official_last_name": "MATTIODA",
        "authorized_official_first_name": "CARL",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "815-673-4363",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MC"
    },
    "taxonomies": [
        {
            "code": "207VH0002X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Hospice and Palliative Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Obstetrics & Gynecology Physician in Streator, IL
• Providers in Streator, IL by specialty
• Obstetrics & Gynecology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2008; 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.