Diane Fodor Mattes, CNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

209006217 Issued in IL

Practice address

5000 S 5TH Ave BLDG 1
Room E236
Hines, IL 60141-3030

Phone

(708) 202-8387

Fax

(708) 202-7402

NPI assigned

Apr 16, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: dfodorapn23406@uchospital.direct-ci.com

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.

• Gibson Community Hospital Association

  dba Gibson Area Hospital and Health Services

  • Critical Access Hospital
  • Gibson City, IL
  • NPI 1114935681
  NPD (past)

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638144000000",
    "number": "1942425673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 S. FIFTH AVE BUILDING 1",
            "address_2": "ROOM E236",
            "city": "HINES",
            "state": "IL",
            "postal_code": "601413030",
            "telephone_number": "708-202-8387",
            "fax_number": "708-202-7402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 S 5TH AVE BLDG 1",
            "address_2": "ROOM E236",
            "city": "HINES",
            "state": "IL",
            "postal_code": "601413030",
            "telephone_number": "708-202-8387",
            "fax_number": "708-202-7402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTES",
        "first_name": "DIANE",
        "middle_name": "FODOR",
        "name_prefix": "Mrs.",
        "credential": "CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-16",
        "last_updated": "2021-11-29",
        "certification_date": "2021-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209006217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "diane.mattes@va.gov",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "5000 S 5th Ave Bldg 1",
            "address_2": "Room E236",
            "city": "Hines",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601413030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Simy Mathew
• Zeena Mathew
• Jamie L Mathews, PSYD
• Sarah Matias
• Pam Matsui
• Jennifer Lynn Mauldin, PHARM.D.
• Ellen Maxson
• Catherine Elizabeth Mazzuca, MSW, LCSW
• Michael G. McCann, LCSW
• Lauren McCarthy

• Nurse Practitioner in Hines, IL
• Providers in Hines, IL by specialty
• Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2021; 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.