Individual provider Active NPI

Camden Macdonald

  • Behavior Technician
  • Elk Grove Village, IL
National Provider Identifier
1194584508
Registry record updated Mar 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
901 Biesterfield Rd Ste 110
Elk Grove Village, IL 60007-3393
Phone
(630) 303-6825
NPI assigned
Mar 18, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Primary

Addresses

Primary practice location

901 Biesterfield Rd Ste 110
Elk Grove Village, IL 60007-3393

Mailing address

901 Biesterfield Rd Ste 110
Elk Grove Village, IL 60007-3393
Phone (630) 303-6825

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

NPI Registry JSON

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

{
    "created_epoch": "1710720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710720000000",
    "number": "1194584508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 BIESTERFIELD RD STE 110",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600073393",
            "telephone_number": "630-303-6825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 BIESTERFIELD RD STE 110",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600073393",
            "telephone_number": "630-303-6825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACDONALD",
        "first_name": "CAMDEN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-18",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk Grove Village, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2024; 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.