Active NPI
Johnnie Phothisene, RBT
- Behavior Technician
- Schaumburg, IL
National Provider Identifier
1033978952
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 1300 Remington Rd Ste K
Schaumburg, IL 60173-4800 - Phone
- (847) 496-5513
- NPI assigned
- Mar 14, 2024
- Sex
- Male
- 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 | IL | Primary |
Addresses
Primary practice location
1300 Remington Rd Ste K
Schaumburg, IL 60173-4800
Mailing address
8201 Cass Ave
Darien, IL 60561-5314
Phone (630) 590-5571
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bys Speech and Occupational Therapy Services, LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Speech-Language Pathologist
- Darien, IL
- NPI 1316224462
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1710374400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1710374400000",
"number": "1033978952",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8201 CASS AVE",
"city": "DARIEN",
"state": "IL",
"postal_code": "605615314",
"telephone_number": "630-590-5571"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1300 REMINGTON RD STE K",
"city": "SCHAUMBURG",
"state": "IL",
"postal_code": "601734800",
"telephone_number": "847-496-5513"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHOTHISENE",
"first_name": "JOHNNIE",
"credential": "RBT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-03-14",
"last_updated": "2024-03-14",
"certification_date": "2024-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Schaumburg, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 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.