DIANE MATTIUZ (NPI# 1952902413) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952902413 |
| Entity Type | Individual |
| Full Name | DIANE MATTIUZ |
| Credential | PHARMD |
| Practice Address |
3401 Freedom Dr Springfield IL 62704-6517 |
| Mailing Address |
6505 Carlisle Bnd Springfield IL 62711-6795 |
| Practice Telephone | 2177933368 |
| Mailing Telephone | 2173615809 |
| Enumeration Date | 2020-11-02 |
| Last Update Date | 2020-11-02 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 051-286472 | IL | Pharmacy Service Providers |
| N | 183500000X | Pharmacist | 051-86472 | IL | Pharmacy Service Providers |
| N | 183500000X | Pharmacist | 051286472 | IL | Pharmacy Service Providers |
| Street Address |
3401 FREEDOM DR |
| City | SPRINGFIELD |
| State | IL |
| Zip Code | 62704-6517 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659398923 | Walmart Inc. | Durable Medical Equipment & Medical Supplies | 3401 Freedom Dr, Springfield, IL 62704-6517 | 2006-07-16 |
| 1720689045 | Nancy Lee Dinges | Pharmacist | 3401 Freedom Dr, Springfield, IL 62704-6517 | 2020-11-03 |
| 1487254876 | Brian Morris | Pharmacist | 3401 Freedom Dr, Springfield, IL 62704-6517 | 2020-10-27 |
| 1972689420 | Wal-mart Stores, Inc | Technician/Technologist | 3401 Freedom Dr, Springfield, IL 62704-6517 | 2006-10-27 |
| 1326129347 | Wal-mart Stores, Inc | Technician/Technologist | 3401 Freedom Dr, Springfield, IL 62704-6517 | 2006-10-17 |
| 1447267240 | William John Irvine | Optometrist | 3401 Freedom Dr, Springfield, IL 62704-6517 | 2006-08-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902394901 | Hillary Haaker | Occupational Therapist | 2035 W Iles, Suite C, Springfield, ID 62704 | 2018-04-25 |
| 1871095364 | Edward Doyle Slifer Sr. | Pathology | 2117 Greenside Drive, Spring Field, IL 62704 | 2018-03-01 |
| 1598263345 | Santarelli & Feller Dental Group | Dentist | 1140 Rickard Road, Suite B, Springfield, IL 62704 | 2018-01-26 |
| 1447774757 | Lisa Ann Rogers | Developmental Therapist | 2101 Lexington Dr, Apt 3, Springfield, IL 62704 | 2017-07-28 |
| 1730611286 | Mindi Rowe | Occupational Therapist | 2508 County Rd 4 1/2 E, Springfield, IL 62704 | 2017-04-03 |
| 1366992208 | Jayme Jordan | Contractor | 2409 Westchester Blvd, Springfield, IL 62704 | 2016-10-04 |
| 1154793974 | Dina Payne | Social Worker | 917 Clocktower Drive, Suite 600, Springfield, IL 62704 | 2015-10-21 |
| 1770959819 | James R Reynolds | Hearing Instrument Specialist | 2347 W Monroe St, Springfield, IL 62704 | 2015-08-12 |
| 1336576495 | Emily Jane Dungey | Counselor | 920 S Spring St Ste 1300, Springfield, IL 62704 | 2013-10-03 |
| 1942552161 | Jeannie Marie Hundley | Specialist/Technologist, Other | 2921 Monvale Drive, Springfield, IL 62704 | 2012-10-11 |
| Find all providers in zip 62704 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255946299 | Vy Dang | Pharmacist | 45 Willow St Apt 510, Springfield, MA 01103-1966 | 2020-09-15 |
| 1114539756 | Logan Meredith Haley | Pharmacist | 6039 New Chapel Rd, Springfield, TN 37172-1338 | 2020-08-17 |
| 1801413349 | Tung Tran | Pharmacist | 1028 Lincoln Ave, Springfield, PA 19064-3923 | 2020-07-01 |
| 1033739453 | John Frederick Endris | Pharmacist | 505 Colbrook Dr, Springfield, IL 62702-3384 | 2020-04-27 |
| 1770103889 | Seth Nelson | Pharmacist | 1150 N 5th St, Springfield, IL 62702-3800 | 2020-04-18 |
| 1952921074 | Edward John Oldfield | Pharmacist | 3441 Smythberry Ln Apt 7, Springfield, IL 62711-8210 | 2020-04-18 |
| 1255965240 | Matthew Sherriffs | Pharmacist | 2 Medical Center Dr Ste 204, Springfield, MA 01107-1271 | 2020-02-27 |
| 1023649134 | Kendra Yociss | Pharmacist | 201 E Madison St, Springfield, IL 62702-5131 | 2020-01-28 |
| 1861049397 | Laura A Kosiorek | Pharmacist | 242 Prentice St, Springfield, MA 01104-1525 | 2019-08-20 |
| 1144880048 | Akemi Nishida | Pharmacist | 520 Ethan Ct, Springfield, OR 97477-9407 | 2019-06-13 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 62704 |
Please comment or provide details below to improve the information on DIANE MATTIUZ.
| 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.