NPIMap

Organization Active NPI

Kankakee Autism Care Therapy

  • Behavior Analyst
  • Custer Park, IL
National Provider Identifier
1124839477
Registry record updated Jan 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
KANKAKEE AUTISM CARE THERAPY
Doing business as
Kankakee Autism Care Therapy
Practice address
35334 Washington St
Custer Park, IL 60481-9157
Phone
(815) 272-6478
NPI assigned
Jan 16, 2025
Last updated
Jan 16, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
AUTISM CARE THERAPYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 16, 2025

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

Authorized official

Name
Kelly K Finnegan
Title
Owner
Phone
(815) 272-6478

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X Primary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X

Addresses

Primary practice location

35334 Washington St
Custer Park, IL 60481-9157

Mailing address

35334 Washington St
Custer Park, IL 60481-9157
Phone (815) 272-6478

Other names 1

  • Kankakee Autism Care Therapy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Kankakee Autism Care Therapy2 organizations share this tax ID, including this one
Part of
Kankakee Autism Care Therapy

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1736985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736985600000",
    "number": "1124839477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35334 WASHINGTON ST",
            "city": "CUSTER PARK",
            "state": "IL",
            "postal_code": "604819157",
            "telephone_number": "815-272-6478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35334 WASHINGTON ST",
            "city": "CUSTER PARK",
            "state": "IL",
            "postal_code": "604819157",
            "telephone_number": "815-272-6478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KANKAKEE AUTISM CARE THERAPY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AUTISM CARE THERAPY",
        "enumeration_date": "2025-01-16",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "status": "A",
        "authorized_official_last_name": "FINNEGAN",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "815-272-6478"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kankakee Autism Care Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Custer Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 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.