Active NPI
Terrence Tom, BCBA
- Behavior Analyst
- Itasca, IL
National Provider Identifier
1184548943
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-26-2831259
- Practice address
- 917 W Hawthorn Dr
Itasca, IL 60143-2056 - Phone
- (847) 465-9556
- Fax
- (847) 465-9621
- NPI assigned
- Aug 5, 2026
- 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 | 1-26-2831259 | IL | Primary |
Addresses
Primary practice location
917 W Hawthorn Dr
Itasca, IL 60143-2056
Mailing address
991 Oak Creek Dr
Lombard, IL 60148-6408
Phone (847) 465-9556
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Funtastic Gymnastic LLC | Behavior Analyst | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1785888000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1785888000000",
"number": "1184548943",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "991 OAK CREEK DR",
"city": "LOMBARD",
"state": "IL",
"postal_code": "601486408",
"telephone_number": "847-465-9556"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "917 W HAWTHORN DR",
"city": "ITASCA",
"state": "IL",
"postal_code": "601432056",
"telephone_number": "847-465-9556",
"fax_number": "847-465-9621"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TOM",
"first_name": "TERRENCE",
"credential": "BCBA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-08-05",
"last_updated": "2026-08-05",
"certification_date": "2026-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "IL",
"license": "1-26-2831259",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Itasca, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.