Provider Demographics
NPI:1275120826
Name:CHRISTINA MATTHEWS LPC LLC
Entity type:Organization
Organization Name:CHRISTINA MATTHEWS LPC LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHLOE
Authorized Official - Middle Name:CHRISTINA
Authorized Official - Last Name:CALDERA
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:312-964-0973
Mailing Address - Street 1:1222 RITTER ST
Mailing Address - Street 2:
Mailing Address - City:NORTH AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60542-8925
Mailing Address - Country:US
Mailing Address - Phone:312-964-0973
Mailing Address - Fax:
Practice Address - Street 1:201 HOUSTON ST SUITE 126
Practice Address - Street 2:
Practice Address - City:BATAVIA
Practice Address - State:IL
Practice Address - Zip Code:60510-1980
Practice Address - Country:US
Practice Address - Phone:312-964-0973
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHRISTINA MATTHEWS LPC LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-12-30
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)