Blue Light ABA Consultants

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

036122339 Issued in IL

Legal business name

BLUE LIGHT ABA CONSULTANTS

Practice address

1100 E Woodfield Rd
Suite 140
Schaumburg, IL 60173-5116

Phone

(847) 278-1885

Fax

(630) 635-2496

NPI assigned

Feb 2, 2016

Last updated

Feb 2, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mir Joffrey, M.D

Title

Medical Director

Phone

(847) 278-1885

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1454371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454371200000",
    "number": "1023476322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 E WOODFIELD RD",
            "address_2": "SUITE 140",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601735116",
            "telephone_number": "847-278-1885",
            "fax_number": "630-635-2496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 E WOODFIELD RD",
            "address_2": "SUITE 140",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601735116",
            "telephone_number": "847-278-1885",
            "fax_number": "630-635-2496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE LIGHT ABA CONSULTANTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-02",
        "last_updated": "2016-02-02",
        "status": "A",
        "authorized_official_last_name": "JOFFREY",
        "authorized_official_first_name": "MIR",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "847-278-1885",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "IL",
            "license": "036122339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Renee Blatt
• BLS Nutrition Consulting LLC
• Blue Anchor Wellness, LLC
• Blue Chip Chiropractic, LLC
• Blue Leaf Dental Associates LLC (Dental Salon Schaumburg)
• Alicia Bobak, FNP
• Kailyn Bobb
• Ronald Joseph Boduch, MD
• Brenda Ann Bogue
• Amy R. Bohland, FNP-BC

• Behavior Analyst in Schaumburg, IL
• Providers in Schaumburg, IL by specialty
• Behavior Analyst in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2016; 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.