Most Relevant Information
Provider Data
| NPI Number: | 1003285560 |
| Provider Name: | MATTISON N PEREZ P.A. |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: | 085005603 |
Most Important Dates
| Enumeration Date: | 09/15/2015 |
| Last Updated: | 03/02/2021 |
Provider Practice Location
4017 ILLINOIS STATE ROUTE 159
SUITE 101
SMITHTON
IL
62285
Practice Location Phone/Fax
| Phone: | 6182572875 |
| Fax: |
Provider Mailing Location
4017 STATE ROUTE 159 STE 101
SMITHTON
IL
622852510
Provider Mailing Phone/Fax
| Phone: | 6182572875 |
| Fax: | 6182572895 |