Provider Demographics
NPI:1649502873
Name:MATHEW, ANITHA ELIZABETH (MD)
Entity type:Individual
Prefix:DR
First Name:ANITHA
Middle Name:ELIZABETH
Last Name:MATHEW
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:2909 N SHERIDAN RD
Mailing Address - Street 2:APT #312
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-5978
Mailing Address - Country:US
Mailing Address - Phone:615-948-4238
Mailing Address - Fax:
Practice Address - Street 1:5841 S MARYLAND AVE
Practice Address - Street 2:MC 5068
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60637-1447
Practice Address - Country:US
Practice Address - Phone:773-702-9500
Practice Address - Fax:773-702-3135
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-15
Last Update Date:2010-02-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL125.053261207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine