Rico J Hale
Individual provider Active NPI Behavior Analyst · Bradley, IL
NPI 1386948685 · NPPES record last updated Dec 29, 2010
Key facts
- NPI
- 1386948685
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Analyst 103K00000X
- Practice address
- 136 142 South Clinton
Bradley, IL 60915 - Phone
- (708) 754-8815
- NPI assigned
- Dec 29, 2010
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grand Prairie Services | Past | Accepting new patients | |
| Grand Prairie Services | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | Yes |
Addresses
Primary practice location
136 142 South Clinton
Bradley, IL 60915
Mailing address
17746 Oak Park Ave
Tinley Park, IL 60477-3936
Phone (708) 444-1012
Other providers in Bradley, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 29, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.