Individual provider Active NPI

Miranda Patricia Yasak

  • Behavior Analyst
  • Chicago, IL
National Provider Identifier
1043129471
Registry record updated Sep 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
1626 N Melvina Ave
Chicago, IL 60639-3918
Phone
(312) 962-9028
NPI assigned
Sep 2, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X IL Primary

Addresses

Primary practice location

1626 N Melvina Ave
Chicago, IL 60639-3918

Mailing address

1626 N Melvina Ave
Chicago, IL 60639-3918
Phone (312) 962-9028

Medicare participation

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

NPI Registry JSON

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

{
    "created_epoch": "1788307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788307200000",
    "number": "1043129471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1626 N MELVINA AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606393918",
            "telephone_number": "312-962-9028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1626 N MELVINA AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606393918",
            "telephone_number": "312-962-9028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YASAK",
        "first_name": "MIRANDA",
        "middle_name": "PATRICIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-09-02",
        "last_updated": "2026-09-02",
        "certification_date": "2026-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.