Stacy Kollanur Mathews, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

1659880698 Issued in IL

Practice address

3275 N Arlington Heights Rd Ste 409&410
Arlington Heights, IL 60004-7709

Phone

(224) 857-8000

Fax

(327) 540-9600

NPI assigned

Mar 24, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1585008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688947200000",
    "number": "1467089177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3275 N ARLINGTON HEIGHTS RD STE 409&410",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600047709",
            "telephone_number": "224-857-8000",
            "fax_number": "327-540-9600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3275 N ARLINGTON HEIGHTS RD STE 409&410",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600047709",
            "telephone_number": "224-857-8000",
            "fax_number": "327-540-9600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHEWS",
        "first_name": "STACY",
        "middle_name": "KOLLANUR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-24",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "1659880698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jaimi P. Mathew, APN-CNP
• Rahael Mathew, LPC
• Rensy Mathew, LCPC
• Siby Mathew
• Tina M. Mathew, APN-CNP
• Mary-Ann M Mathias, MD
• Paula Mathiasen
• Matrix Bathroom Systems
• Kosta Nikolov Matrov, M.D.
• Jacob Matsil, DO

• Pediatrics Physician in Arlington Heights, IL
• Providers in Arlington Heights, IL by specialty
• Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2023; 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.