Elizabeth Bodner, MS, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-17-26652

Practice address

1308 Waukegan Rd Ste 103
Glenview, IL 60025-3070

Phone

(847) 486-4140

NPI assigned

Aug 2, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

Practice roles

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.

• North Shore Pediatric Therapy

  • Pediatric Occupational Therapist
  • Glenview, IL
  • NPI 1811909492

  Behavior Analyst

  NPD (past)
• Pediatric Therapy

  • Developmental Disabilities Clinic/Center
  • Glenview, IL
  • NPI 1093011579
  NPD (past)
• PCT Speech Therapy PLLC

  • Speech-Language Pathologist
  • Southlake, TX
  • NPI 1427436872
  NPD (past)
• Pine Cone Therapies LLC

  • Behavior Analyst
  • Southlake, TX
  • NPI 1013143767
  NPD (past)

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

{
    "created_epoch": "1501632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674604800000",
    "number": "1053835702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 LEE ST STE 210",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600166574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1308 WAUKEGAN RD STE 103",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600253070",
            "telephone_number": "847-486-4140"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2104 Greenbriar Dr Ste A",
            "address_purpose": "LOCATION",
            "city": "Southlake",
            "state": "TX",
            "postal_code": "760928355",
            "country_code": "US",
            "telephone_number": "817-442-9022",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BODNER",
        "first_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "MS, BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-02",
        "last_updated": "2023-01-25",
        "certification_date": "2023-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "1-17-26652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blue Sage Wellness, Inc
• Andrea Lynn Blume, COTA L
• Dawn Blundell, PTA/L
• Kevin Dale Boatwright, MD
• Laina Bobrov
• Miriam Boelen, PT
• Blair Bogard, PA-C
• Sydney Boland
• Boldly You Psychotherapy
• Colleen Bolotin, APN-CNP

• Behavior Analyst in Glenview, IL
• Providers in Glenview, IL by specialty
• Behavior Analyst in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2023; 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.