Michelle Lopez

Individual provider Active NPI Behavior Technician · Ashkum, IL

NPI 1174489082 · NPPES record last updated Jan 5, 2026

Key facts

NPI
1174489082
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
309 E Washington St
Ashkum, IL 60911-7094
Phone
(773) 915-3379
NPI assigned
Jan 5, 2026
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X IL Yes

Addresses

Primary practice location

309 E Washington St
Ashkum, IL 60911-7094

Mailing address

309 E Washington St
Ashkum, IL 60911-7094
Phone (773) 915-3379

Other providers in Ashkum, IL

All providers in Ashkum, IL · Behavior Technician in Illinois

Sources for this page

Verify at the official NPI Registry.