Individual provider Active NPI

Priscila Flygare

  • Behavior Technician
  • Rockford, IL
National Provider Identifier
1043700321
Registry record updated May 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
1851418 Issued in IL
Practice address
1410 Monticello LN
Rockford, IL 61107-2425
Phone
(779) 537-4260
NPI assigned
May 13, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X 1851418 IL Primary

Addresses

Primary practice location

1410 Monticello LN
Rockford, IL 61107-2425

Mailing address

1410 Monticello LN
Rockford, IL 61107-2425
Phone (779) 537-4260

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

LicenseStateTypeSpecialty
1851418ILMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1526169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526169600000",
    "number": "1043700321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1410 MONTICELLO LN",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611072425",
            "telephone_number": "779-537-4260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 MONTICELLO LN",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611072425",
            "telephone_number": "779-537-4260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLYGARE",
        "first_name": "PRISCILA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-13",
        "last_updated": "2018-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "IL",
            "license": "1851418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 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.

Verify at the official NPI Registry.