Active NPI
Holli Clauser, RBT-17-34670
- Behavior Technician
- Lake Villa, IL
National Provider Identifier
1417459942
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- 17-34670
- Practice address
- 410 Hampton Dr
Lake Villa, IL 60046-5067 - Phone
- (224) 999-5180
- NPI assigned
- Feb 28, 2018
- Last updated
- Feb 28, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 | 17-34670 | IL | Primary |
Addresses
Primary practice location
410 Hampton Dr
Lake Villa, IL 60046-5067
Mailing address
410 Hampton Dr
Lake Villa, IL 60046-5067
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 |
|---|---|---|---|
| 17-34670 | IL | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1519776000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1519776000000",
"number": "1417459942",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "410 HAMPTON DR",
"city": "LAKE VILLA",
"state": "IL",
"postal_code": "600465067"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "410 HAMPTON DR",
"city": "LAKE VILLA",
"state": "IL",
"postal_code": "600465067",
"telephone_number": "224-999-5180"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLAUSER",
"first_name": "HOLLI",
"credential": "RBT-17-34670",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-02-28",
"last_updated": "2018-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "IL",
"license": "17-34670",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Villa, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 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.