Individual provider Active NPI

Sabrina Wilson, BCBA

  • Behavior Analyst
  • Palos Heights, IL
National Provider Identifier
1124615505
Registry record updated Aug 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
152001086 Issued in IL
Practice address
11755 Southwest Hwy
Palos Heights, IL 60463-1015
Phone
(708) 586-4239
NPI assigned
Dec 31, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 152001086 IL Primary

Addresses

Primary practice location

11755 Southwest Hwy
Palos Heights, IL 60463-1015

Mailing address

11755 Southwest Hwy
Palos Heights, IL 60463-1015
Phone (708) 586-4239

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
152001086ILMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1609372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756512000000",
    "number": "1124615505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11755 SOUTHWEST HWY",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631015",
            "telephone_number": "708-586-4239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11755 SOUTHWEST HWY",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631015",
            "telephone_number": "708-586-4239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "SABRINA",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-31",
        "last_updated": "2025-08-30",
        "certification_date": "2025-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "IL",
            "license": "152001086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palos Heights, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2025; 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.