Active NPI
Miranda J Lopez
- Behavior Technician
- Warrenville, IL
National Provider Identifier
1043866684
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 3S261 Tracy PL
Warrenville, IL 60555-2925 - Phone
- (630) 903-8051
- NPI assigned
- Aug 9, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 | Primary |
Addresses
Primary practice location
3S261 Tracy PL
Warrenville, IL 60555-2925
Mailing address
3S261 Tracy PL
Warrenville, IL 60555-2925
Phone (630) 903-8051
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1565308800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1565308800000",
"number": "1043866684",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3S261 TRACY PL",
"city": "WARRENVILLE",
"state": "IL",
"postal_code": "605552925",
"telephone_number": "630-903-8051"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3S261 TRACY PL",
"city": "WARRENVILLE",
"state": "IL",
"postal_code": "605552925",
"telephone_number": "630-903-8051"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOPEZ",
"first_name": "MIRANDA",
"middle_name": "J",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-08-09",
"last_updated": "2019-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Warrenville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.