Active NPI
Brazil Z Jenkins
- Behavior Technician
- Naperville, IL
National Provider Identifier
1326867268
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-22-208773
- Practice address
- 2323 Naper VL Rd Ste 265
Naperville, IL 60563-3486 - Phone
- (847) 465-9556
- NPI assigned
- Oct 8, 2024
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-22-208773 | MO | Primary |
Addresses
Primary practice location
2323 Naper VL Rd Ste 265
Naperville, IL 60563-3486
Mailing address
991 Oak Creek Dr
Lombard, IL 60148-6408
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-22-208773 | MO | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Funtastic Gymnastic LLC | Behavior Technician | Current | Accepting new patients |
Locations
991 Oak Creek Dr
Lombard, IL 60148
Phone (312) 882-5237
Organizations & group practices 1
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": "1728345600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728345600000",
"number": "1326867268",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "991 OAK CREEK DR",
"city": "LOMBARD",
"state": "IL",
"postal_code": "601486408"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2323 NAPER VL RD STE 265",
"city": "NAPERVILLE",
"state": "IL",
"postal_code": "605633486",
"telephone_number": "847-465-9556"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENKINS",
"first_name": "BRAZIL",
"middle_name": "Z",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-10-08",
"last_updated": "2024-10-08",
"certification_date": "2024-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "MO",
"license": "RBT-22-208773",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Naperville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 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.