Active NPI
Annette Grandolfo, BCBA
- Behavior Analyst
- Aurora, IL
National Provider Identifier
1013307776
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-14-17577
- Practice address
- 452 N Eola Rd
Aurora, IL 60502 - Phone
- (888) 308-3728
- NPI assigned
- Feb 2, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-14-17577 | IL | Primary |
Addresses
Primary practice location
452 N Eola Rd
Aurora, IL 60502
Mailing address
452 N Eola Rd
Aurora, IL 60502-9612
Phone (888) 308-3728
Other practice location 1
1500 NW Bethany Blvd
Suite 320
Beaverton, OR 97006-5208
Phone (503) 567-3260
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1422835200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1562112000000",
"number": "1013307776",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "452 N EOLA RD",
"city": "AURORA",
"state": "IL",
"postal_code": "605029612",
"telephone_number": "888-308-3728"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "452 N EOLA RD",
"city": "AURORA",
"state": "IL",
"postal_code": "60502",
"telephone_number": "888-308-3728"
}
],
"practiceLocations": [
{
"address_1": "1500 NW Bethany Blvd",
"address_2": "Suite 320",
"address_purpose": "LOCATION",
"city": "Beaverton",
"state": "OR",
"postal_code": "970065208",
"country_code": "US",
"telephone_number": "503-567-3260",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GRANDOLFO",
"first_name": "ANNETTE",
"name_prefix": "Ms.",
"credential": "BCBA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-02-02",
"last_updated": "2019-07-03",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "IL",
"license": "1-14-17577",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Aurora, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.