Active NPI
Kelsey Peters
- Behavior Technician
- Batavia, IL
National Provider Identifier
1023595873
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- 15-08503
- Practice address
- 150 Houston St Ste 300
Batavia, IL 60510-1995 - Phone
- (847) 336-2237
- NPI assigned
- Jul 24, 2018
- Sex
- Female
- Sole proprietor
- No
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 Technician | 106S00000X | 15-08503 | IL | Primary |
Addresses
Primary practice location
150 Houston St Ste 300
Batavia, IL 60510-1995
Mailing address
1315A Modaff Rd # 6
Naperville, IL 60565-6118
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 15-08503 | Medicaid | IL |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15-08503 | IL | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1532390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1532390400000",
"number": "1023595873",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1315A MODAFF RD # 6",
"city": "NAPERVILLE",
"state": "IL",
"postal_code": "605656118"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "150 HOUSTON ST STE 300",
"city": "BATAVIA",
"state": "IL",
"postal_code": "605101995",
"telephone_number": "847-336-2237"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERS",
"first_name": "KELSEY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-07-24",
"last_updated": "2018-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "IL",
"license": "15-08503",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "15-08503",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Batavia, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.