Active NPI
Timothy Misseldine
- Behavior Analyst
- Alsip, IL
National Provider Identifier
1154130425
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 5167 W 111TH St
Alsip, IL 60803-6021 - Phone
- (773) 524-2551
- NPI assigned
- Jan 2, 2025
- Last updated
- Jan 2, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | Primary |
Addresses
Primary practice location
5167 W 111TH St
Alsip, IL 60803-6021
Mailing address
916 193Rd PL
Chicago Heights, IL 60411-7520
Phone (563) 419-7731
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1735776000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1735776000000",
"number": "1154130425",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "916 193RD PL",
"city": "CHICAGO HEIGHTS",
"state": "IL",
"postal_code": "604117520",
"telephone_number": "563-419-7731"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5167 W 111TH ST",
"city": "ALSIP",
"state": "IL",
"postal_code": "608036021",
"telephone_number": "773-524-2551"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MISSELDINE",
"first_name": "TIMOTHY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-01-02",
"last_updated": "2025-01-02",
"certification_date": "2025-01-02",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Alsip, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 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.