| Doctor Name: | DR. KELLINE EVANS MATHEWS |
| NPI Number: | 1154648160 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PSY.D. |
| License Number: | 071.005973 |
| Business Practice Address: | 201 E Army Trail Rd Ste 306 Bloomingdale, IL - 601082138 |
| Business Phone Number: | 6305392620 |
| Business Fax Number: | |
| Mailing Address: | 201 E Army Trail Rd Ste 306, BLOOMINGDALE |
| State: | IL |
| Postal Code: | 601082138 |
| Phone Number: | 6305392620 |
| Fax Number: | |
| NPI Enumeration Date: | 04/29/2010 |
| NPI Last Update Date: | 01/17/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TA0400X |
| License Number: | 071.005973 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |