NPIMap

Organization Active NPI

Early Intervention for Autism, LLC.

  • Behavior Analyst
  • Glenview, IL
National Provider Identifier
1417490988
Registry record updated Nov 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-10-7063 Issued in IL
Legal business name
EARLY INTERVENTION FOR AUTISM, LLC.
Practice address
3503 Linneman St
Glenview, IL 60025-3923
Phone
(847) 915-0164
Fax
(888) 840-8715
NPI assigned
Nov 30, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2016

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

Authorized official

Name
Jennifer Mihm, BCBA
Title
Owner/Clinical Director
Phone
(847) 915-0164

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 103K00000X 1-10-7063 IL Primary

Addresses

Primary practice location

3503 Linneman St
Glenview, IL 60025-3923

Mailing address

3503 Linneman St
Glenview, IL 60025-3923
Phone (847) 915-0164

National Provider Directory

National Provider Directory
Tax ID family
Early Intervention for Autism LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1480464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480464000000",
    "number": "1417490988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3503 LINNEMAN ST",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600253923",
            "telephone_number": "847-915-0164",
            "fax_number": "888-840-8715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3503 LINNEMAN ST",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600253923",
            "telephone_number": "847-915-0164",
            "fax_number": "888-840-8715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EARLY INTERVENTION FOR AUTISM, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-30",
        "last_updated": "2016-11-30",
        "status": "A",
        "authorized_official_last_name": "MIHM",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OWNER/CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "847-915-0164",
        "authorized_official_credential": "BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": "IL",
            "license": "1-10-7063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenview, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2016; 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.