Individual provider Active NPI

Casey Baldus, BCBA

  • Behavior Analyst
  • Chicago, IL
National Provider Identifier
1407425895
Registry record updated Jun 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
BACB445861 Issued in IN
Practice address
1422 W Willow St Ste 10
Chicago, IL 60642-8978
Phone
(773) 630-4400
NPI assigned
Jun 21, 2021
Last updated
Jun 21, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X BACB445861 IN Primary

Addresses

Primary practice location

1422 W Willow St Ste 10
Chicago, IL 60642-8978

Mailing address

1422 W Willow St Ste 10
Chicago, IL 60642-8978
Phone (773) 630-4400

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

LicenseStateTypeSpecialty
BACB445861INMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
ABA Midwest Education LTD Behavior Analyst 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1624233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624233600000",
    "number": "1407425895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1422 W WILLOW ST STE 10",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606428978",
            "telephone_number": "773-630-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1422 W WILLOW ST STE 10",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606428978",
            "telephone_number": "773-630-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALDUS",
        "first_name": "CASEY",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-21",
        "last_updated": "2021-06-21",
        "certification_date": "2021-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "IN",
            "license": "BACB445861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.