Doctor Name: | DR. JAMIE L MATHEWS |
NPI Number: | 1013257153 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PSYD |
License Number: | 071.008513 |
Business Practice Address: | 5000 S 5th Ave Hines, IL - 601413030 |
Business Phone Number: | 7082028387 |
Business Fax Number: | |
Mailing Address: | 5000 S 5th Ave, HINES |
State: | IL |
Postal Code: | 601413030 |
Phone Number: | 7082028387 |
Fax Number: | |
NPI Enumeration Date: | 02/27/2013 |
NPI Last Update Date: | 02/27/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 071.008513 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |