Active NPI
Andrea Harris
- Behavior Technician
- Homewood, IL
National Provider Identifier
1346088481
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 19150 Kedzie Ave Ste 208
Homewood, IL 60430-4541 - Phone
- (312) 478-8467
- Fax
- (312) 284-2375
- NPI assigned
- Jul 15, 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 | Primary |
Addresses
Primary practice location
19150 Kedzie Ave Ste 208
Homewood, IL 60430-4541
Mailing address
2038 221St St
Sauk Village, IL 60411-5064
Phone (312) 478-8467
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
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Building Blocks of Life LLC | Behavior Technician | Current | Accepting new patients |
Locations
19150 Kedzie Ave
Ste 208
Homewood, IL 60430
Phone (312) 478-8467
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": "1721001600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721001600000",
"number": "1346088481",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2038 221ST ST",
"city": "SAUK VILLAGE",
"state": "IL",
"postal_code": "604115064",
"telephone_number": "312-478-8467"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19150 KEDZIE AVE STE 208",
"city": "HOMEWOOD",
"state": "IL",
"postal_code": "604304541",
"telephone_number": "312-478-8467",
"fax_number": "312-284-2375"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRIS",
"first_name": "ANDREA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-07-15",
"last_updated": "2024-07-15",
"certification_date": "2024-07-05",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Homewood, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 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.