Active NPI
Cynthia Bardell
- Behavior Analyst
- Wheaton, IL
National Provider Identifier
1073017398
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-20-43375
- Practice address
- 140 E Loop Rd
Wheaton, IL 60189-8407 - Phone
- (312) 243-8487
- NPI assigned
- Mar 21, 2018
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-17-46043 | IL | |
| Behavior Analyst | 103K00000X | 1-20-43375 | IL | Primary |
Addresses
Primary practice location
140 E Loop Rd
Wheaton, IL 60189-8407
Mailing address
847 Staghorn LN Apt 102
North Aurora, IL 60542-1424
Phone (815) 990-8480
Other practice location 1
150 Houston St
Batavia, IL 60510-1953
Phone (815) 223-2237
Other practice location 2
2422 W Main St Unit 4C
St Charles, IL 60175-1010
Phone (815) 990-8480
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| UWBAN2675853 | Other | IL | BLUECROSS BLUESHIELD |
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
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-17-46043 | IL | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1521590400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620172800000",
"number": "1073017398",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "847 STAGHORN LN APT 102",
"city": "NORTH AURORA",
"state": "IL",
"postal_code": "605421424",
"telephone_number": "815-990-8480"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "140 E LOOP RD",
"city": "WHEATON",
"state": "IL",
"postal_code": "601898407",
"telephone_number": "312-243-8487"
}
],
"practiceLocations": [
{
"address_1": "150 Houston St",
"address_purpose": "LOCATION",
"city": "Batavia",
"state": "IL",
"postal_code": "605101953",
"country_code": "US",
"telephone_number": "815-223-2237",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2422 W Main St Unit 4C",
"address_purpose": "LOCATION",
"city": "St Charles",
"state": "IL",
"postal_code": "601751010",
"country_code": "US",
"telephone_number": "815-990-8480",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BARDELL",
"first_name": "CYNTHIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-03-21",
"last_updated": "2021-05-05",
"certification_date": "2021-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "IL",
"license": "RBT-17-46043",
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "IL",
"license": "1-20-43375",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSS BLUESHIELD",
"identifier": "UWBAN2675853",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wheaton, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.