Active NPI
Corin Duffek, RBT
- Behavior Technician
- Park Ridge, IL
National Provider Identifier
1356039655
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-23-268602
- Practice address
- 444 N Northwest Hwy Ste 195
Park Ridge, IL 60068-6403 - Phone
- (847) 707-6744
- NPI assigned
- Apr 26, 2023
- 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-23-268602 | IL | Primary |
Addresses
Primary practice location
444 N Northwest Hwy Ste 195
Park Ridge, IL 60068-6403
Mailing address
PO Box 639561
Cincinnati, OH 45263-6395
Phone (480) 896-2219
Other practice location 1
2762 N Lincoln Ave
Chicago, IL 60614-2425
Phone (844) 247-7222
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-23-268602 | IL | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Autism Home Support Services, Inc | Behavior Technician | Past | Accepting new patients |
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.
-
- Behavior Analyst
- Northbrook, IL
- NPI 1770818841
Behavior Technician
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1682467200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1688515200000",
"number": "1356039655",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 639561",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452636395",
"telephone_number": "480-896-2219"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "444 N NORTHWEST HWY STE 195",
"city": "PARK RIDGE",
"state": "IL",
"postal_code": "600686403",
"telephone_number": "847-707-6744"
}
],
"practiceLocations": [
{
"address_1": "2762 N Lincoln Ave",
"address_purpose": "LOCATION",
"city": "Chicago",
"state": "IL",
"postal_code": "606142425",
"country_code": "US",
"telephone_number": "844-247-7222",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DUFFEK",
"first_name": "CORIN",
"credential": "RBT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-04-26",
"last_updated": "2023-07-05",
"certification_date": "2023-07-05",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "IL",
"license": "RBT-23-268602",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Park Ridge, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.