Sydney Mata

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

RBT-22-242237 Issued in IL

Practice address

3815 E. Main Street
Suite B
Saint Charles, IL 60174

Phone

(630) 584-7530

Fax

(630) 584-7762

NPI assigned

Nov 3, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1667433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1023725470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3815 E. MAIN STREET",
            "address_2": "SUITE B",
            "city": "SAINT CHARLES",
            "state": "IL",
            "postal_code": "60174",
            "telephone_number": "630-584-7530",
            "fax_number": "630-584-7762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3815 E. MAIN STREET",
            "address_2": "SUITE B",
            "city": "SAINT CHARLES",
            "state": "IL",
            "postal_code": "60174",
            "telephone_number": "630-584-7530",
            "fax_number": "630-584-7762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATA",
        "first_name": "SYDNEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-03",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "IL",
            "license": "RBT-22-242237",
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyssa Ann Martire, M.S CCC-SLP
• John C Mason, DDS
• Michael Masoncup, D.D.S
• Massey Family Chiropractic & Wellness Center PC
• Sheryar Masud, D.C.
• Jennifer J Mathew, D.O.
• Lauren Danae Matovu, MSW, LCSW
• Janna Matthis, SOCIAL WORKER
• Bridgette Alexandra Maurino, LCSW
• Thomas Joseph Maurovich, DDS

• Behavior Technician in Saint Charles, IL
• Providers in Saint Charles, IL by specialty
• Behavior Technician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2024; 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.