Bryn Aleah Favakeh

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

RBT-16-15039 Issued in TX

Practice address

2530 Ridge Ave
Evanston, IL 60201-2492

Phone

(847) 869-0892

NPI assigned

Jul 6, 2022

Last updated

Jul 6, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• North Suburban Pediatrics, SC

  • Pediatrics Physician
  • Evanston, IL
  • NPI 1780729145

  Single Specialty

  NPD (past)
• Pine Cone Therapies LLC

  • Behavior Analyst
  • Southlake, TX
  • NPI 1013143767

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1657065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657065600000",
    "number": "1164155289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2104 GREENBRIAR DR",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760928355",
            "telephone_number": "817-442-9022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2530 RIDGE AVE",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602012492",
            "telephone_number": "847-869-0892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAVAKEH",
        "first_name": "BRYN",
        "middle_name": "ALEAH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-06",
        "last_updated": "2022-07-06",
        "certification_date": "2022-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Technician",
            "state": "TX",
            "license": "RBT-16-15039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elaine Farrell, MD
• Laurie J. Farrell, PA-C
• Claire K Farren, CRNA
• Dawn E. Farwell, APN-CNS
• Adelina Fassakhova, MD
• John Kenneth Favale
• Rachel Joy Fear, CNM
• Julia Terese Feczko, MS, CRNA
• Emily A. Feeny, PA-C
• Carrie Lynne Fehr, MT-BC

• Behavior Technician in Evanston, IL
• Providers in Evanston, IL by specialty
• Behavior Technician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2022; 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.