Jenna Ann Pronger

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Practice address

4201 W 93Rd St
Oak Lawn, IL 60453-1998

Phone

(708) 423-0150

NPI assigned

Jan 4, 2013

Last updated

Sep 24, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1357257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569283200000",
    "number": "1417294927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10360 S 84TH AVE",
            "city": "PALOS HILLS",
            "state": "IL",
            "postal_code": "604651702",
            "telephone_number": "708-983-3101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 W 93RD ST",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604531998",
            "telephone_number": "708-423-0150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRONGER",
        "first_name": "JENNA",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-04",
        "last_updated": "2019-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED PROFESSIONAL COUNSELOR",
            "identifier": "178.008085",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED CLINICAL PROFESSIONAL COUNSELOR",
            "identifier": "180.009347",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Behavior Analyst in Oak Lawn, IL
• Providers in Oak Lawn, IL by specialty
• Behavior Analyst in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2019; 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.