Individual provider Active NPI

Eva Malek Chahrour

  • Behavior Technician
  • Dearborn, MI
National Provider Identifier
1083221907
Registry record updated Sep 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
C660238579547 Issued in MI
Practice address
19853 Outer Dr
Dearborn, MI 48124-2066
Phone
(313) 406-5056
NPI assigned
Sep 24, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X C660238579547 MI Primary

Addresses

Primary practice location

19853 Outer Dr
Dearborn, MI 48124-2066

Mailing address

22945 Marlboro St
Dearborn, MI 48128-1888
Phone (313) 788-4788

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

LicenseStateTypeSpecialty
C660238579547MIMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1600905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600905600000",
    "number": "1083221907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22945 MARLBORO ST",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481281888",
            "telephone_number": "313-788-4788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19853 OUTER DR",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242066",
            "telephone_number": "313-406-5056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAHROUR",
        "first_name": "EVA",
        "middle_name": "MALEK",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-24",
        "last_updated": "2020-09-24",
        "certification_date": "2020-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "MI",
            "license": "C660238579547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2020; 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.