Provider Demographics
NPI:1497224943
Name:MATHEW, JAIMI P (APN-CNP)
Entity type:Individual
Prefix:
First Name:JAIMI
Middle Name:P
Last Name:MATHEW
Suffix:
Gender:F
Credentials:APN-CNP
Other - Prefix:
Other - First Name:JAIMI
Other - Middle Name:JOAN
Other - Last Name:PHILIP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:800 W CENTRAL RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-2349
Mailing Address - Country:US
Mailing Address - Phone:877-780-9064
Mailing Address - Fax:847-618-3259
Practice Address - Street 1:800 W CENTRAL RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-2349
Practice Address - Country:US
Practice Address - Phone:877-780-9064
Practice Address - Fax:847-618-3259
Is Sole Proprietor?:No
Enumeration Date:2018-11-14
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.018157363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL209018157OtherSTATE LICENSE