Active NPI
Taylor Pinkham
- Behavior Analyst
- Bloomington, IL
National Provider Identifier
1306403852
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-22-60334
- Practice address
- 202 Saint Joseph Dr
Bloomington, IL 61701-3638 - Phone
- (309) 386-1177
- NPI assigned
- May 21, 2019
- Sex
- Female
- Sole proprietor
- No
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 | RBT-19-105973 | IL | |
| Behavior Analyst | 103K00000X | 1-22-60334 | Primary |
Addresses
Primary practice location
202 Saint Joseph Dr
Bloomington, IL 61701-3638
Mailing address
507 E Armstrong Ave
Peoria, IL 61603-3201
Phone (309) 686-1177
Other practice location 1
507 E Armstrong Ave
Peoria, IL 61603-3201
Phone (309) 686-1177
Other names 1
- Taylor Potrzebowski
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-19-105973 | IL | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Easter Seals - Ucp | Behavior Analyst | Past | Accepting new patients |
| Easter Seals - Ucp | Behavior Analyst | 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.
-
- Behavior Analyst
- Peoria, IL
- NPI 1083983738
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1558396800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1773792000000",
"number": "1306403852",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "507 E ARMSTRONG AVE",
"city": "PEORIA",
"state": "IL",
"postal_code": "616033201",
"telephone_number": "309-686-1177",
"fax_number": "309-686-7722"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "202 SAINT JOSEPH DR",
"city": "BLOOMINGTON",
"state": "IL",
"postal_code": "617013638",
"telephone_number": "309-386-1177"
}
],
"practiceLocations": [
{
"address_1": "507 E Armstrong Ave",
"address_purpose": "LOCATION",
"city": "Peoria",
"state": "IL",
"postal_code": "616033201",
"country_code": "US",
"telephone_number": "309-686-1177",
"fax_number": "309-686-7722",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PINKHAM",
"first_name": "TAYLOR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-05-21",
"last_updated": "2026-03-18",
"certification_date": "2026-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "IL",
"license": "RBT-19-105973",
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": "1-22-60334",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "TAYLOR",
"last_name": "POTRZEBOWSKI",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Bloomington, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 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.