Samuel Jesse Blockson

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Practice address

6419 W 87TH St
Oak Lawn, IL 60453-1048

Phone

(708) 634-0821

NPI assigned

Sep 28, 2021

Sex

Male

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

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

{
    "created_epoch": "1632787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632787200000",
    "number": "1184396103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21600 OXNARD ST STE 1800",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913677807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6419 W 87TH ST",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604531048",
            "telephone_number": "708-634-0821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOCKSON",
        "first_name": "SAMUEL",
        "middle_name": "JESSE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-09-28",
        "last_updated": "2021-09-28",
        "certification_date": "2021-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lakeisha Black
• Maureen Blanchfield-Okeefe, PT
• Nicholas Andrew Blaney
• Tom Blicharski, APN
• Adam R. Block, D.O.
• Brian Blumenstein, MD
• Wilfred Boarden, M.D.
• Vishal Bobba, MD
• Sarah Boersma, FNP
• Susan Boettcher, RD, LDN

• All providers in Oak Lawn, IL
• Behavior Analyst in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2021; 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.