NPIMap

Organization Active NPI

Indivisual LLC

  • Behavior Analyst
  • Chicago, IL
National Provider Identifier
1073909941
Registry record updated Jun 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1107278 Issued in IL
Legal business name
INDIVISUAL LLC
Practice address
5911 N Leader Ave
Chicago, IL 60646-5625
Phone
(773) 332-7382
NPI assigned
Apr 7, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2016

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

Authorized official

Name
Miss Jayme Lynn Crooks, BCBA
Title
President
Phone
(773) 332-7382

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X 1107278 IL Primary

Addresses

Primary practice location

5911 N Leader Ave
Chicago, IL 60646-5625

Mailing address

5911 N Leader Ave
Chicago, IL 60646-5625
Phone (773) 332-7382

National Provider Directory

National Provider Directory
Tax ID family
Bridges Academy LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1428364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466553600000",
    "number": "1073909941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5911 N LEADER AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606465625",
            "telephone_number": "773-332-7382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5911 N LEADER AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606465625",
            "telephone_number": "773-332-7382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIVISUAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-07",
        "last_updated": "2016-06-22",
        "status": "A",
        "authorized_official_last_name": "CROOKS",
        "authorized_official_first_name": "JAYME",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-332-7382",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": "IL",
            "license": "1107278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2016; 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.