NPIMap

Individual provider Active NPI

Alexis Fernandez

  • Behavior Analyst
  • Westchester, IL
National Provider Identifier
1093131278
Registry record updated Jan 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-20-46788 Issued in IL
Practice address
2255 Enterprise Dr Ste 5501
Westchester, IL 60154-5808
Phone
(708) 965-4123
NPI assigned
Mar 11, 2014
Last updated
Jan 4, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 4306 MA
Behavior Analyst 103K00000X 5532 TX
Behavior Analyst 103K00000X 1-20-46788 IL Primary
Behavior Technician 106S00000X NU

Addresses

Primary practice location

2255 Enterprise Dr Ste 5501
Westchester, IL 60154-5808

Mailing address

2000 N Lincoln Park W Unit 707
Chicago, IL 60614-4708
Phone (702) 480-9295

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
5532TXMDBehavioral Analyst
4306MAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Cortica Developmental Therapies PA PastSince Jan 8, 2023 Accepting new patients
Cortica Healthcare Inc Past Accepting new patients
Cortica ABA Therapies PA Behavior Analyst PastSince Jan 8, 2023 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14973/brand/8/csg/1/fhir/r4

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1394496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672790400000",
    "number": "1093131278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 N LINCOLN PARK W UNIT 707",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606144708",
            "telephone_number": "702-480-9295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2255 ENTERPRISE DR STE 5501",
            "city": "WESTCHESTER",
            "state": "IL",
            "postal_code": "601545808",
            "telephone_number": "708-965-4123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "ALEXIS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-11",
        "last_updated": "2023-01-04",
        "certification_date": "2023-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MA",
            "license": "4306",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "TX",
            "license": "5532",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "IL",
            "license": "1-20-46788",
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westchester, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 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.