Active NPI
Kerry Sivertsen
- Behavior Analyst
- Chicago, IL
National Provider Identifier
1154760106
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 103K00000X
- Practice address
- 30 E Huron St
Unit 1106
Chicago, IL 60611-2766 - Phone
- (847) 997-7157
- NPI assigned
- Jun 21, 2013
- Sex
- Female
- 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 | 103K00000X | Primary |
Addresses
Primary practice location
30 E Huron St
Unit 1106
Chicago, IL 60611-2766
Mailing address
541 Cress Creek CT
Crystal Lake, IL 60014-7055
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": "1371772800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1371772800000",
"number": "1154760106",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "541 CRESS CREEK CT",
"city": "CRYSTAL LAKE",
"state": "IL",
"postal_code": "600147055"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30 E HURON ST",
"address_2": "UNIT 1106",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606112766",
"telephone_number": "847-997-7157"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIVERTSEN",
"first_name": "KERRY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-06-21",
"last_updated": "2013-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": "103K00000X",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.