NPIMap

Individual provider Active NPI

A. K. Mathew, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Chicago, IL
National Provider Identifier
1992817191
Registry record updated Jan 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
036050312 Issued in IL
Practice address
4177 S Archer Ave
Chicago, IL 60632-1849
Phone
(773) 254-2222
Fax
(773) 254-8444
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 036050312 IL Primary

Addresses

Primary practice location

4177 S Archer Ave
Chicago, IL 60632-1849

Mailing address

PO Box 3663
Oak Brook, IL 60522-3663
Phone (773) 254-2222

Other identifiers 1

IdentifierTypeStateIssuer
036050312MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101230000346 IL Practitioner - Internal MedicinePractitioner - Endocrinology 4880882117 Practice locations: Chicago, IL

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Endocrinology
Education
Other, 1969
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3600 W Roosevelt Rd
Chicago, IL 60624-4225
Phone (773) 638-6761

4177 S Archer Ave
Chicago, IL 60632-1849
Phone (773) 254-2222

Hospital & facility affiliations

  • Anuco Home Health Care LLC Home health agency, Chicago, IL, CCN 148390
  • Saint Anthony Hospital Hospital, Chicago, IL, CCN 140095
  • Holy Cross Hospital Hospital, Chicago, IL, CCN 140133

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Holy Cross Hospital Past Accepting new patients

Organizations & group practices 1

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.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737936000000",
    "number": "1992817191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3663",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605223663",
            "telephone_number": "773-254-2222",
            "fax_number": "773-254-8444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4177 S ARCHER AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606321849",
            "telephone_number": "773-254-2222",
            "fax_number": "773-254-8444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHEW",
        "first_name": "A.",
        "middle_name": "K.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "IL",
            "license": "036050312",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036050312",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.