Kelline Evans Mathews, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

071.005973 Issued in IL

Practice address

201 E Army Trail Rd Ste 306
Bloomingdale, IL 60108-2138

Phone

(630) 539-2620

NPI assigned

Apr 29, 2010

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Wolfson Psychological Services, P.C.

  • Clinical Psychologist
  • Highland Park, IL
  • NPI 1194851477
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1272499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358380800000",
    "number": "1154648160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 E ARMY TRAIL RD STE 306",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "601082138",
            "telephone_number": "630-539-2620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E ARMY TRAIL RD STE 306",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "601082138",
            "telephone_number": "630-539-2620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHEWS",
        "first_name": "KELLINE",
        "middle_name": "EVANS",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-29",
        "last_updated": "2013-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IL",
            "license": "071.005973",
            "primary": true
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "IL",
            "license": "071.005973",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "IL",
            "license": "071.005973",
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "IL",
            "license": "071.005973",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Massage Studio Inc.
• Nicholas Masse, MD
• Christopher Daniel Matesi, D.D.S
• Febin Mathew
• Priya Sanil Mathew, APN
• Sunil N Matiwala, M.D.
• Kathleen Mattes
• Matthew Albin OD LLC (Insight Vision Care)
• Leslie Dalaza Mattson, M.D.
• Joseph Michael Matustik, D.D.S.

• Psychologist in Bloomingdale, IL
• Providers in Bloomingdale, IL by specialty
• Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.