Lerian K Mathews
Nurse Practitioner, Family in Chicago, IL. Individual provider (NPI-1).
NPI number1104721182
StatusActive
Last updated in NPPESOct 10, 2026
Details
- NPI
- 1104721182
- Entity type
- Individual (NPI-1)
- Name
- Mr. Lerian K Mathews
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Oct 10, 2026
- Certification date
- Oct 10, 2026
- Last updated
- Oct 10, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | F05240166 | IL | Yes |
Practice location
7305 S Clyde AveChicago, IL 60649-3108
Phone 773-988-5428
Mailing address
7305 S Clyde AveChicago, IL 60649-3108
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