NPIMap

Organization Active NPI

Chicago Behavior & Learning Group Inc.

  • Behavior Analyst
  • Chicago, IL
National Provider Identifier
1205219136
Registry record updated Mar 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-10-7620 Issued in IL
Legal business name
CHICAGO BEHAVIOR & LEARNING GROUP INC.
Practice address
1737 N Wilmot Ave
Chicago, IL 60647-5523
Phone
(757) 660-9320
NPI assigned
Jul 9, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2016

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

Authorized official

Name
Nicole Jansma, M.S., BCBA
Title
Bcba/President
Phone
(757) 660-9320

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 103K00000X 1-10-7620 IL Primary

Addresses

Primary practice location

1737 N Wilmot Ave
Chicago, IL 60647-5523

Mailing address

1737 N Wilmot Ave
Chicago, IL 60647-5523

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1436400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459123200000",
    "number": "1205219136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1737 N WILMOT AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606475523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1737 N WILMOT AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606475523",
            "telephone_number": "757-660-9320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHICAGO BEHAVIOR & LEARNING GROUP INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-09",
        "last_updated": "2016-03-28",
        "status": "A",
        "authorized_official_last_name": "JANSMA",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "BCBA/PRESIDENT",
        "authorized_official_telephone_number": "757-660-9320",
        "authorized_official_credential": "M.S., BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": "IL",
            "license": "1-10-7620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2016; 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.