NPIMap

Organization Active NPI

ABA of Wisconsin, LLC

  • Community/Behavioral Health Agency
  • Woodridge, IL
National Provider Identifier
1104209923
Registry record updated Jan 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
ABA OF WISCONSIN, LLC
Practice address
1501 Dogwood Dr
Woodridge, IL 60517-4649
Phone
(715) 600-2211
Fax
(630) 395-9198
NPI assigned
Jun 30, 2015
Last updated
Jan 26, 2016By the provider in NPPES
Organization subpart
Yes
Parent organization
ABA OF ILLINOIS, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 26, 2016

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

Authorized official

Name
Erin Raber
Title
Program Manager
Phone
(715) 600-2211

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

1501 Dogwood Dr
Woodridge, IL 60517-4649

Mailing address

1501 Dogwood Dr
Woodridge, IL 60517-4649
Phone (715) 600-2211

National Provider Directory

National Provider Directory
Part of
ABA of Illinois LLC

Locations

10930 W Potter Rd
Ste A
Wauwatosa, WI 53226
Phone (262) 200-0900

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1435622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453766400000",
    "number": "1104209923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 DOGWOOD DR",
            "city": "WOODRIDGE",
            "state": "IL",
            "postal_code": "605174649",
            "telephone_number": "715-600-2211",
            "fax_number": "630-395-9198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 DOGWOOD DR",
            "city": "WOODRIDGE",
            "state": "IL",
            "postal_code": "605174649",
            "telephone_number": "715-600-2211",
            "fax_number": "630-395-9198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABA OF WISCONSIN, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ABA OF ILLINOIS, LLC",
        "enumeration_date": "2015-06-30",
        "last_updated": "2016-01-26",
        "status": "A",
        "authorized_official_last_name": "RABER",
        "authorized_official_first_name": "ERIN",
        "authorized_official_title_or_position": "PROGRAM MANAGER",
        "authorized_official_telephone_number": "715-600-2211"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodridge, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 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.