LESLIE MATHERS III


Address: 1701 E College Ave, Bloomington, IL 61704-2101
Phone: 3096643038

LESLIE MATHERS III (NPI# 1487675161) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1487675161
Entity Type Individual
Full Name LESLIE MATHERS III
Credential M.D.
Practice Address 1701 E College Ave
Bloomington
IL 61704-2101
Mailing Address 602 W University Ave
Urbana
IL 61801-2530
Practice Telephone 3096643038
Mailing Telephone 2173833311
Enumeration Date 2006-07-21
Last Update Date 2009-11-17
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2083X0100X Preventive Medicine
Specialization: Occupational Medicine
036055260 IL Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
IL MEDICARE GROUP PTAN IL2613 01

Office Location

Street Address 1701 E COLLEGE AVE
City BLOOMINGTON
State IL
Zip Code 61704-2101

Providers in the same location

NPI Name Taxonomy Address Enumeration
1982602140 Brandy Lynn Redman Occupational Therapist 1701 E College Ave, Bloomington, IL 61704-2101 2005-07-12
1336777515 Paula Roberts Nurse Practitioner 1701 E College Ave, Bloomington, IL 61704-2101 2020-04-01
1689150948 Barbara Luann Weis Psychiatry & Neurology 1701 E College Ave, Bloomington, IL 61704-2101 2018-07-18
1366949224 Kayla Marie Hnilicka Registered Nurse 1701 E College Ave, Bloomington, IL 61704-2101 2018-04-09
1992227052 Christine C Gardner Nurse Practitioner 1701 E College Ave, Bloomington, IL 61704-2101 2017-07-11
1033652243 Sonal Mukesh Patel Nurse Practitioner 1701 E College Ave, Bloomington, IL 61704-2101 2016-11-21
1285013029 Andrew Tharp Nurse Practitioner 1701 E College Ave, Bloomington, IL 61704-2101 2015-05-27
1154670073 Amy Lynn Nelson Occupational Therapist 1701 E College Ave, Bloomington, IL 61704-2101 2012-09-06
1336403237 Derrick Alwyn Fox Psychiatry & Neurology 1701 E College Ave, Bloomington, IL 61704-2101 2012-06-26
1437434982 Abbi Carr Nurse Practitioner 1701 E College Ave, Bloomington, IL 61704-2101 2011-10-17
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Taxonomy Information

Taxonomy Code 2083X0100X
Grouping Allopathic & Osteopathic Physicians
Classification Preventive Medicine
Specialization Occupational Medicine

Taxonomy Definition

Occupational medicine focuses on the health of workers, including the ability to perform work; the physical, chemical, biological, and social environments of the workplace; and the health outcomes of environmental exposures. Practitioners in this field address the promotion of health in the work place, and the prevention and management of occupational and environmental injury, illness, and disability.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Preventive Medicine, 2007. http://www.abprevmed.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Preventive Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1265746689 Floyd Edward Thurston Preventive Medicine 3310 E Mulberry Ct, Bloomington, IN 47401-2425 2010-07-27
1023278207 Dorothy J. Lenzi Preventive Medicine 301 N Curry Pike, Bloomington, IN 47404-2502 2008-06-11
1508048133 Kirsten Marie Koos Preventive Medicine 8500 Normandale Lake Blvd, Bloomington, MN 55437-3813 2007-12-05
1902066400 St Joseph Medical Center Preventive Medicine 1505 Eastland Dr, Suite 1000, Bloomington, IL 61701-3534 2008-06-10
1881715290 John Stewart Jacoby Preventive Medicine 600 W 98th St, Bloomington, MN 55420-4773 2007-04-03

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1356816466 Taylor Nicole Rich Preventive Medicine 2408 Hampshire Dr Apt 2, Champaign, IL 61820-1215 2018-10-05
1720517568 Avrom Simon Preventive Medicine 128 S Aberdeen St Unit 5s, Chicago, IL 60607-1507 2017-06-06
1215332531 Cheryl Culberson Preventive Medicine 350 Surryse Rd Ste 110, Lake Zurich, IL 60047-3217 2014-10-29
1497018493 Brian Charles Svazas Preventive Medicine 211 Kenilworth Ave, Glen Ellyn, IL 60137-5324 2012-06-25
1205129764 Zbigniev Durlak Preventive Medicine 9930 Stratford L, Palos Hills, IL 60465 2011-05-17
1609168657 New Life Pentecostal Medical Clinic for The Uninsured Inc Preventive Medicine 183 N Schuyler Ave, Kankakee, IL 60901-3828 2011-05-10
1821305269 Daniel Alexander Bakston Preventive Medicine 835 S. Wolcott Ave E-144, University of Illinois Medical Center, Chicago, IL 60612-4006 2010-09-07
1194951913 Sonya Meyers Preventive Medicine 835 S Wolcott Ave # E144, Chicago, IL 60612-3748 2009-06-08
1073755021 Afiz A. Taiwo, Md. Mph. S.c. Preventive Medicine 309 Pinehurst Dr, Palos Heights, IL 60463-2911 2009-04-06
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Competitor

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City BLOOMINGTON
Zip Code 61704

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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