Individual provider Active NPI

Nina Mathew, MD

  • Family Medicine Physician
  • Lombard, IL
National Provider Identifier
1992384630
Registry record updated Oct 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036-170192 Issued in IL
Practice address
1801 S Highland Ave Ste 130
Lombard, IL 60148-4932
Phone
(630) 627-4722
Fax
(630) 627-9134
NPI assigned
Apr 7, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2024

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 036-170192 IL Primary

Addresses

Primary practice location

1801 S Highland Ave Ste 130
Lombard, IL 60148-4932

Mailing address

Pob 7132960
Chicago, IL 60677-0001
Phone (630) 469-9200

Other practice location 1

7306 Summit Rd
Darien, IL 60561-3529
Phone (224) 399-7368

Electronic endpoints 2

TypeEndpointUseAffiliation
Other URL drninamathew@yahoo.com
Direct Messaging Address nmathew277078@dulyhealthandcare.direct-ci.com Direct

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
I20240920002606 IL Practitioner - Family Practice 5395286058 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2018
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

Practice addresses (Care Compare)

1801 S Highland Ave
Lombard, IL 60148-4932
Phone (630) 627-4722

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-170192ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dupage Medical Group LTD CurrentSince Oct 7, 2024 Accepting new patients
Dupage Medical Group LTD CurrentSince Oct 7, 2024 Accepting new patients
Citizens Medical Center County of Victoria Past Accepting new patients

Locations

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

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

1801 S Highland Ave
Ste 130
Lombard, IL 60148
Phone (630) 627-4722

1801 S Highland Ave
Lombard, IL 60148
Phone (630) 627-4722

Interoperability endpoints

  • Direct secure messaging: nmathew277078@dulyhealthandcare.direct-ci.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1617753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728000000000",
    "number": "1992384630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "POB 7132960",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606770001",
            "telephone_number": "630-469-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 S HIGHLAND AVE STE 130",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601484932",
            "telephone_number": "630-627-4722",
            "fax_number": "630-627-9134"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7306 Summit Rd",
            "address_purpose": "LOCATION",
            "city": "Darien",
            "state": "IL",
            "postal_code": "605613529",
            "country_code": "US",
            "telephone_number": "224-399-7368",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATHEW",
        "first_name": "NINA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-07",
        "last_updated": "2024-10-04",
        "certification_date": "2024-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-170192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "drninamathew@yahoo.com",
            "affiliation": "N",
            "address_1": "7306 Summit Rd",
            "city": "Darien",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605613529",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nmathew277078@dulyhealthandcare.direct-ci.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1801 S Highland Ave Ste 130",
            "city": "Lombard",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601484932",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lombard, IL

Sources for this page

Verify at the official NPI Registry.