Active NPI
Nicole McKenzie
- Behavior Analyst
- Oak Lawn, IL
National Provider Identifier
1194480392
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 9115 S Cicero Ave Ste 200
Oak Lawn, IL 60453-1771 - Phone
- (773) 449-0859
- NPI assigned
- Nov 2, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | |||
| Behavior Analyst | 103K00000X | Primary |
Addresses
Primary practice location
9115 S Cicero Ave Ste 200
Oak Lawn, IL 60453-1771
Mailing address
14840 Shepard Dr
Dolton, IL 60419-2467
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 |
|---|---|---|---|
| Functional Skills Group | Behavior Analyst | Past | Accepting new patients |
| Achievers ABA LLC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Community/Behavioral Health Agency
- Indianapolis, IN
- NPI 1366037053
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1635811200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1637884800000",
"number": "1194480392",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14840 SHEPARD DR",
"city": "DOLTON",
"state": "IL",
"postal_code": "604192467"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9115 S CICERO AVE STE 200",
"city": "OAK LAWN",
"state": "IL",
"postal_code": "604531771",
"telephone_number": "773-449-0859"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCKENZIE",
"first_name": "NICOLE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-11-02",
"last_updated": "2021-11-26",
"certification_date": "2021-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oak Lawn, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 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.