Active NPI
Jackie Rayyan
- Behavior Technician
- Lake Bluff, IL
National Provider Identifier
1366943672
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-17-42708
- Practice address
- 917 Sherwood Drive, Suite 201
Lake Bluff, IL 60048 - Phone
- (877) 486-4140
- NPI assigned
- Feb 22, 2018
- Last updated
- Feb 22, 2018
- 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-17-42708 | IL | Primary |
Addresses
Primary practice location
917 Sherwood Drive, Suite 201
Lake Bluff, IL 60048
Mailing address
950 Lee Street, Suite 210
Des Plaines, IL 60016
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-17-42708 | IL | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1519257600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1519257600000",
"number": "1366943672",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "950 LEE STREET, SUITE 210",
"city": "DES PLAINES",
"state": "IL",
"postal_code": "60016"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "917 SHERWOOD DRIVE, SUITE 201",
"city": "LAKE BLUFF",
"state": "IL",
"postal_code": "60048",
"telephone_number": "877-486-4140"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAYYAN",
"first_name": "JACKIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-02-22",
"last_updated": "2018-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "IL",
"license": "RBT-17-42708",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Bluff, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.