Jasmin Raheem

Individual provider Active NPI Behavior Technician · Worth, IL

NPI 1053165993 · NPPES record last updated Apr 16, 2024

Key facts

NPI
1053165993
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
License
RBT-24-341257 (IL)
Practice address
11301 S Harlem Ave
Worth, IL 60482-2001
Phone
(708) 586-2604
NPI assigned
Apr 16, 2024
Sex
Female
Sole proprietor
No

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.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
RBT-24-341257ILMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Asd Life Inc. Current
since Feb 2, 2025
Accepting new patients

Locations

11301 S Harlem Ave
Worth, IL 60482
Phone (708) 305-3697

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-24-341257 IL Yes

Addresses

Primary practice location

11301 S Harlem Ave
Worth, IL 60482-2001

Mailing address

8614 Wyman Dr
Tinley Park, IL 60487-8403
Phone (708) 856-6282

Other providers in Worth, IL

All providers in Worth, IL · Behavior Technician in Illinois

Sources for this page

Verify at the official NPI Registry.