Individual provider Active NPI

Stefanie Paola Maurtua, BCBA

  • Behavior Analyst
  • Chicago, IL
National Provider Identifier
1457872475
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
BACB288453 Issued in IL
Practice address
2448 West Bloomingdale Ave.
Apt 2E
Chicago, IL 60647
Phone
(630) 550-6932
NPI assigned
Jun 29, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 BACB288453 IL Primary

Addresses

Primary practice location

2448 West Bloomingdale Ave.
Apt 2E
Chicago, IL 60647

Mailing address

2448 W Bloomingdale Ave Apt 2E
Chicago, IL 60647-6920
Phone (630) 550-6932

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
BACB288453ILMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1498694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1457872475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2448 W BLOOMINGDALE AVE APT 2E",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606476920",
            "telephone_number": "630-550-6932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2448 WEST BLOOMINGDALE AVE.",
            "address_2": "APT 2E",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60647",
            "telephone_number": "630-550-6932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAURTUA",
        "first_name": "STEFANIE",
        "middle_name": "PAOLA",
        "name_prefix": "Miss",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-29",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "IL",
            "license": "BACB288453",
            "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 Jul 21, 2022; 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.