Active NPI
Carley Decore
- Behavior Analyst
- Joliet, IL
National Provider Identifier
1376244178
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-23-64659
- Practice address
- 3033 W Jefferson St Ste 105
Joliet, IL 60435-5249 - Phone
- (224) 291-8831
- NPI assigned
- Mar 17, 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 Analyst | 103K00000X | 1-23-64659 | IL | Primary |
Addresses
Primary practice location
3033 W Jefferson St Ste 105
Joliet, IL 60435-5249
Mailing address
8609 W Bryn Mawr Ave Ste 204
Chicago, IL 60631-3524
Phone (773) 644-7787
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1679011200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1680998400000",
"number": "1376244178",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8609 W BRYN MAWR AVE STE 204",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606313524",
"telephone_number": "773-644-7787"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3033 W JEFFERSON ST STE 105",
"city": "JOLIET",
"state": "IL",
"postal_code": "604355249",
"telephone_number": "224-291-8831"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DECORE",
"first_name": "CARLEY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-03-17",
"last_updated": "2023-04-09",
"certification_date": "2023-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "IL",
"license": "1-23-64659",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Joliet, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 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.