NPIMap

Organization Active NPI

Indivisual ABA

  • Student in an Organized Health Care Education/Training Program
  • Aurora, IL
National Provider Identifier
1194168823
Registry record updated Apr 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Legal business name
INDIVISUAL ABA
Practice address
1984 Sedgegrass TRL
Aurora, IL 60504-4329
Phone
(217) 317-9688
NPI assigned
Apr 11, 2013
Last updated
Apr 11, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2013

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

Authorized official

Name
Angela Daniels
Title
Behavior Specialist
Phone
(217) 317-9688

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU Primary

Addresses

Primary practice location

1984 Sedgegrass TRL
Aurora, IL 60504-4329

Mailing address

1984 Sedgegrass TRL
Aurora, IL 60504-4329
Phone (217) 317-9688

National Provider Directory

National Provider Directory
Tax ID family
Achieve Beyond Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1365638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365638400000",
    "number": "1194168823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1984 SEDGEGRASS TRL",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605044329",
            "telephone_number": "217-317-9688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1984 SEDGEGRASS TRL",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605044329",
            "telephone_number": "217-317-9688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIVISUAL ABA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-11",
        "last_updated": "2013-04-11",
        "status": "A",
        "authorized_official_last_name": "DANIELS",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "BEHAVIOR SPECIALIST",
        "authorized_official_telephone_number": "217-317-9688"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 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.

Verify at the official NPI Registry.