Alessandra Altom

Individual provider Active NPI Behavior Analyst · Bolingbrook, IL

NPI 1033825567 · NPPES record last updated Jan 27, 2023

Key facts

NPI
1033825567
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Analyst 103K00000X
License
1-22-63261 (IL)
Practice address
484 W Boughton Rd Ste C
Bolingbrook, IL 60440-2478
Phone
(312) 858-8562
NPI assigned
Jan 27, 2023
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst
Group: 193400000X SINGLE SPECIALTY GROUP
103K00000X 1-22-63261 IL Yes

Addresses

Primary practice location

484 W Boughton Rd Ste C
Bolingbrook, IL 60440-2478

Mailing address

1102 Chippewa St
Normal, IL 61761-5760
Phone (224) 587-0552

Other providers in Bolingbrook, IL

All providers in Bolingbrook, IL · Behavior Analyst in Illinois

Sources for this page

Verify at the official NPI Registry.