Functional Immunology, PLLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

FUNCTIONAL IMMUNOLOGY, PLLC

Practice address

838 Columbia Cir
North Aurora, IL 60542-1812

Phone

(630) 448-0545

Fax

(630) 326-8652

NPI assigned

Jan 24, 2026

Organization subpart

No

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

Authorized official

Name

Stanley Mathew, MD

Title

Owner

Phone

(646) 531-1151

Specialties & licenses 1

Addresses

Other names 1

• The Young Clinic Functional Medicine Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Haley Young, PA-C

  • Physician Assistant
  • North Aurora, IL
  • NPI 1073157582
  NPD

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

{
    "created_epoch": "1769212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786492800000",
    "number": "1508715491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "855 A AVE NE STE 105",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524025060",
            "telephone_number": "646-531-1151",
            "fax_number": "319-369-8251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "838 COLUMBIA CIR",
            "city": "NORTH AURORA",
            "state": "IL",
            "postal_code": "605421812",
            "telephone_number": "630-448-0545",
            "fax_number": "630-326-8652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUNCTIONAL IMMUNOLOGY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-24",
        "last_updated": "2026-08-12",
        "certification_date": "2026-08-12",
        "status": "A",
        "authorized_official_last_name": "MATHEW",
        "authorized_official_first_name": "STANLEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "646-531-1151",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Young Clinic Functional Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Madelyn Fogle
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• Fox Valley Physician Services SC
• Freedom 1St Home Care Incorporated
• Emily L Frey, PSY.D.
• Russell James Giese Jr., MD
• Cory Giguere, MSW, LSW
• Ankush Goel, MD
• Chris E Gonzales, MS, NCC, LPC
• Graceful Care LLC

• General Practice Physician in North Aurora, IL
• Providers in North Aurora, IL by specialty
• General Practice Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2026; 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.