Individual provider Active NPI

Kathleen Gardner, BCBA

  • Behavior Analyst
  • Mokena, IL
National Provider Identifier
1275814519
Registry record updated Mar 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
9500 Bormet Dr
Mokena, IL 60448-8303
Phone
(815) 469-1500
NPI assigned
Aug 31, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X Primary

Addresses

Primary practice location

9500 Bormet Dr
Mokena, IL 60448-8303

Mailing address

9500 Bormet Dr Ste 304
Mokena, IL 60448-8399
Phone (815) 469-1500

Other identifiers 1

IdentifierTypeStateIssuer
887686217COtherPHCS PPO (PRIVATE INSURANCE)

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

OrganizationSpecialtyStatusNew patients
Djje Holdings LLC Behavior Analyst Past Accepting new patients
The Place for Speech Therapy LLC Past Accepting new patients
Eyas Landing, Inc. Past Accepting new patients
Westside Childrens Therapy Past Accepting new patients

Organizations & group practices 4

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": "1314748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773878400000",
    "number": "1275814519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9500 BORMET DR STE 304",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604488399",
            "telephone_number": "815-469-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 BORMET DR",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604488303",
            "telephone_number": "815-469-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "KATHLEEN",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-31",
        "last_updated": "2026-03-19",
        "certification_date": "2026-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHCS PPO (PRIVATE INSURANCE)",
            "identifier": "887686217C",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mokena, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 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.

Verify at the official NPI Registry.